This document contains:
- Living Will
- Medical Power of Attorney
Laws
Statutes – Title 50, Chapter 9, Part 1: Montana Rights of the Terminally Ill Act
Definition – “Declaration” means a document executed in accordance with the requirements of Section 103 (§ 50-9-102(5)).
Statutory Forms – Living Will (50-9-103(2)), Medical POA (50-9-103(3))
Signing Requirements – Acknowledgment of Two (2) Witnesses (§ 50-9-103(1))
Revocation – Revocation of Declaration (§ 50-9-104), Health Care Power of Attorney Not Revoked Until Notice (§ 72-5-502)
Other Versions (7)
- AARP
- Everplans
- Five Wishes (Aging with Dignity)
- Montana State University
- Prepare for Your Care
- Spanish/Español Version
- St. Peter’s Health
Download: Adobe PDF
Instructions: Adobe PDF
Download: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Montana State University Version
Download: Adobe PDF
Download: Adobe PDF
In Spanish: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
How to File
The Office of Consumer Protection maintains an End-of-Life Registry (pursuant to § 50-9-501) that can be accessed online so that residents of the state can file their advance directives into a local database. The agency provides the following two (2) documents:
- Consumer Registration Agreement – A form submitted by individuals who have completed an advance directive so that its contents can be archived.
- Health Care Provider Registration Agreement – Medical professionals wishing to view patients’ advance directives must execute a copy of this form to gain access to the registry.
Additional Resources
- Benefis Health System – Your Healthcare Preferences: Advance Care Planning
- Montana Board of Medical Examiners – POLST Guidance for Medical Professionals
- Montana Legal Services Association – How to Use the My Choices Advance Directive
- Montana State University – Body Donation Program
- Montana State University – End-of-Life Registry Guide
- Montana State University – Rights of the Terminally Ill Act
- Montana State University – What Are Your Rights Over Your Remains?
- My Choices – Advance Directive, Living Will, and POLST Information
- SCL Health – Advance Care Planning in Montana
Related Forms (10)
- Consumer Registration Agreement
- Durable (Financial) Power of Attorney
- End of Life Worksheet
- Health Care Provider Registration Agreement
- HIPAA Authorization (Form HPS-401)
- Mental Health Care Advance Directive
- Organ Donation Form
- POLST Bracelet & Necklace Order Form
- Provider Orders for Life‐Sustaining Treatment (POLST) Form
- Revocation of Medical Power of Attorney
Consumer Registration Agreement (for Advance Directive)
Download: Adobe PDF
In Spanish: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Download: Adobe PDF
Health Care Provider Registration Agreement (for Access to Registry)
Download: Adobe PDF
HIPAA Authorization (Form HPS-401)
Download: Adobe PDF
Mental Health Care Advance Directive
Download: Adobe PDF
Instructions: Adobe PDF
Laws: 53-21-1301 – 53-21-1335
Download: Adobe PDF
POLST Bracelet & Necklace Order Form
Download: Adobe PDF
Provider Orders for Life‐Sustaining Treatment (POLST) Form
Download: Adobe PDF
Instructions: Adobe PDF
Revocation of Medical Power of Attorney
Download: Adobe PDF, MS Word (.docx)
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