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Laws
Statutes – RS 40:1151 et seq.
Definition – “Declaration” means a witnessed document, statement, or expression voluntarily made by the declarant, authorizing the withholding or withdrawal of life-sustaining procedures, in accordance with the requirements of this Subpart. A declaration may be made in writing, orally, or by other means of nonverbal communication. (§ 1151.1(4))
Statutory Form – § 1151.2(C)(1)
Signing Requirements – Acknowledgment of Two (2) Witnesses (§ 1151.2(A)(2))
Revocation – § 1151.3
Other Versions (5)
- Franciscan Missionaries of Our Lady Health System
- LSU Health
- Ochsner Health System
- Peoples Health
- Spanish/Español
Franciscan Missionaries of Our Lady Health System Version
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
Additional Resources
- Lallie Kemp Medical Center – You Decide Brochure
- Louisiana Healthcare Connections – Advance Medical Directives
- Louisiana State Bar – End-of-Life Decisions
- Ochsner Health – Advance Care Planning Conversations (in Spanish, in Vietnamese)
- Peoples Health – Louisiana Advance Directives Handout
Related Forms (6)
- Advance Directive (Medical POA & Living Will)
- Advance Directive for Mental Health Treatment
- Advance Directive Wallet Cards
- Durable (Financial) Power of Attorney
- HIPAA Authorization Form
- Physician Orders for Scope of Treatment (LaPOST) Form
Advance Directive (Medical POA & Living Will)
Download: Adobe PDF
Advance Directive for Mental Health Treatment
Download: Adobe PDF
Laws: RS 28:221 et sec.
Advance Directive Wallet Cards
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
HIPAA Authorization Form (specific to Blue Cross, Blue Shield, & HMO)
Download: Adobe PDF
Physician Orders for Scope of Treatment (LaPOST) Form
Download: Adobe PDF
Spanish Version: Adobe PDF
Laws: RS 40:1155.1 et seq.
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