Nebraska Advance Directive Form (Medical POA & Living Will)

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The Nebraska Advance Directive signifies a prearranged compilation designed to record a person’s wishes regarding health care. The document is comprised of a living will and a power of attorney for health care and allows the declarant to proclaim medical treatment preferences should they become incapacitated. Assignment of a designated agent can be affirmed along with the desired course of action concerning life-support, pain management, and resuscitation. Filing an additional Emergency Treatment Declaration will assert to further document choices to cover a broader range of selections.

Other Versions (9)

AARP (Caring Connections) Version

Download: Adobe PDF
Instructions: Adobe PDF

 

 


Avera Health Version

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Bryan Medical Center Version

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Information: Adobe PDF

 

 


Five Wishes (Aging with Dignity) Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Kimball Health Services Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Nebraska Catholic Conference Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Nebraska Medicine Version (also available in Spanish/en Español)

Download: Adobe PDF
Information: Adobe PDF

 

 


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

Download: Adobe PDF

 

 

 


Spanish Version

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Additional Resources

Related Forms (5)

Advance Directive Wallet Card

Download: Adobe PDF

 

 

 


Durable (Financial) Power of Attorney

Download: Adobe PDF

 

 

 


Emergency Treatment Declaration (also available for a Minor)

Download: Adobe PDF
Information: Adobe PDF

 

 

 


Physician’s Do-Not-Resuscitate (DNR) Order

Download: Adobe PDF

 

 

 


Psychiatric Advance Directive

Download: Adobe PDF
Information: Adobe PDF