The Mississippi Advance Directive is the standard document performed by those that aspire to record their wishes ahead of time. Whether you’re someone who is facing serious medical issues or a perfectly healthy person, it is always considered a good idea to establish your desired healthcare preferences before potentially falling into an incapacitated state. This form allows users to describe how they want certain treatments to occur and who they see fit to make decisions for them should they become unresponsive. It merely requires the recording of the health care agent’s identity, their instructions for any end-of-life procedures, and the nomination of a primary physician (optional). The instrument must then be signed in front of witnesses and/or a notarial officer to put the terms into effect.
This document contains the following sections:
- Part I: Power of Attorney for Health Care
- Part II: Instructions for Health Care (Living Will)
- Part III: Designation of Primary Physician (Optional)
The Mississippi Organ Recovery Agency (MORA) allows individuals within the area to enroll in the National Donor Registry for those interested in donating organs and tissues at the time of death.
Laws
Statutes – Mississippi Uniform Health-Care Decisions Act (§ 41-41-201 – § 41-41-229)
Definition – “Advance health-care directive” means an individual instruction or a power of attorney for health care (§ 41-41-203(b)).
Statutory Form – § 41-41-209
Signing Requirements – Acknowledgment of Two (2) Witnesses and/or a Notary Public (§ 41-41-205(2))
Revocation – § 41-41-207
Other Versions (9)
- AARP
- Five Wishes (Aging with Dignity)
- Forrest Health
- Mississippi State University
- North Mississippi Medical Center
- OCH Regional Medical Center
- Prepare for Your Care
- Spanish/Español
- University of Mississippi Medical Center
Download: Adobe PDF
Instructions: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Download: Adobe PDF
Mississippi State University Version
Download: Adobe PDF
North Mississippi Medical Center Version
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
University of Mississippi Medical Center (UMMC) Version
Download: Adobe PDF
Additional Resources
- Forrest Health – PSDA and Advance Directive Information
- Mississippi State University – Advance Directive Guide
- North Mississippi Medical Center – Conversations Before the Crisis Workbook
Related Forms
Advance Directive Wallet Cards
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Physician Orders for Sustaining Treatment (POST) Form
Download: Adobe PDF