This Document Contains:
Laws
Statutes – Advance Directive Information (20 ILCS 2310/2310-600)
Definition – The advance directive contained on this page is the combination of the following documents and their definitions:
- Medical Power of Attorney – Appoints a “health care agent” which is an individual at least eighteen (18) years old designated by the principal to make health care decisions of any type, including, but not limited to, anatomical gift, autopsy, or disposition of remains for and on behalf of the individual (755 ILCS 45/4-4(e-5)).
- Living Will – Referred to as a “declaration” which is a witnessed document in writing, in a hard copy or electronic format, voluntarily executed by the declarant in accordance with the requirements of Section 3 (755 ILCS 35/2(b)).
Signing Requirements – The medical power of attorney section of the form requires the signature of at least one (1) qualified witness (755 ILCS 45/4-5.1(a)), whereas the living will portion necessitates the signatures of two (2) eligible witnesses (755 ILCS 35/3(b)).
Other Versions (6)
- AARP (Caring Connections)
- Compassion & Choices
- Five Wishes (Aging with Dignity)
- Memorial Hospital Shiloh
- Prepare for Your Care
- Spanish/Español
AARP (Caring Connections) Version
Download: Adobe PDF
Instructions: Adobe PDF
Download: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Memorial Hospital Shiloh Version
Download: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Download: Adobe PDF
Additional Resources
- Catholic Conference of Illinois – A Catholic Perspective on Advance Directives
- Illinois Department of Public Health – DNR/POLST Guidance for Individuals
- Illinois Department of Public Health – DNR/POLST Guidance for Professionals
- Illinois Secretary of State – Organ Donation Registry Information
- Illinois State Medical Society – POLST Survey
- Sarah Bush Lincoln Health System – Living Wills and POA for Healthcare
Related Forms (6)
- Advance Directive Wallet Cards
- Declaration for Mental Health Treatment
- Do-Not-Resuscitate (DNR) Order Form
- Durable (Financial) Power of Attorney
- Practitioner Orders for Life-Sustaining Treatment (POLST) Form
- Statement of Illinois Law on Advance Directives
Advance Directive Wallet Cards
Download: Adobe PDF
Declaration for Mental Health Treatment
Download: Adobe PDF
Spanish Version: Adobe PDF
Laws: 755 ILCS 43
Do-Not-Resuscitate (DNR) Order Form
Download: Adobe PDF
Spanish Version: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Practitioner Orders for Life-Sustaining Treatment (POLST) Form
Download: Adobe PDF
Spanish Version: Adobe PDF
Statement of Illinois Law on Advance Directives
Download: Adobe PDF
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