Indiana Advance Directive (Medical POA & Living Will) Form

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The Indiana Advance Directive (Medical POA & Living Will) is a multi-functional form that gives its executors the opportunity to declare their wishes regarding life-ending care as well as appoint a representative to handle certain medical decisions on their behalf. More and more states are adopting this format as it makes it easier for the public to convey their wishes in one cohesive document. If this appeals to you, you will need to make sure to transcribe the details of both parties within the instrument, indicate your choices regarding healthcare, and sign the form corresponding with Indiana law (signing requirements listed below).

To register as an organ donor within the state, visit the Donate Life Indiana website to begin the process.

Other Versions (4)

AARP Version

Download: Adobe PDF
Instructions: Adobe PDF

 

 


Indiana Catholic Conference Version

Download: Adobe PDF

 

 

 


Prepare for Your Care Version (also available in Spanish/en Español)

Download: Adobe PDF

 

 

 


Spanish/Español Version

Download: Adobe PDF

 

 

 

Additional Resources

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Download: Adobe PDF, MS Word (.docx)

 

 

 


Life-Prolonging Procedures Declaration (Form 55315)

Download: Adobe PDF, MS Word (.docx)
IUH Version: Adobe PDF
Spanish Version: Adobe PDF
Laws: § 16-36-4-11

 


Organ Donation Form

Download: Adobe PDF

 

 

 


Physician Orders for Scope of Treatment – POST (Form 55317)

Download: Adobe PDF, MS Word (.docx)
Laws: § 16-36-6