Laws
Statute – Rhode Island Health Care Power of Attorney (§ 23-4.10) and Rhode Island Rights of the Terminally Ill Act (§ 23-4.11)
Definitions – “Advance directive protocol” means a standardized, state-wide method developed for emergency medical services personnel by the department of health and approved by the ambulance service advisory board, of providing palliative care to, and withholding life-sustaining procedures from, a qualified patient (§ 23-4.11-2(1)).
Signing Requirements – An actively instated notary or two (2) subscribing witnesses, unrelated by blood or marriage, must be present to corroborate the endorsement process to verify its commitment (§ 23-4.10-2).
Revocation – § 23-4.10-3 and § 23-4.11-4
Other Versions (6)
- AARP (Caring Connections)
- eForms
- Five Wishes (Aging with Dignity)
- Hope Health
- Prepare for Your Care
- Roman Catholic Diocese of Providence
AARP (Caring Connections) Version
Download: Adobe PDF
Instructions: Adobe PDF
Download: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Hope Health Version (also available in Spanish/en Español)
Download: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Roman Catholic Diocese of Providence Version
Download: Adobe PDF
Instructions: Adobe PDF
Additional Resources
- Healthcentric Advisors – Information for Patients, Families, and Caregivers
- Lifespan Health System – About Advance Directives
- New England Donor Services – Organ Donation FAQ’s
- Roman Catholic Diocese of Providence – End-of-Life Decisions Guide
- State of Rhode Island Department of Health – Advance Directives
- State of Rhode Island Department of Health – Medical Orders for Life-Sustaining Treatment (MOLST)
Related Forms (3)
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Medical Orders for Life-Sustaining Treatment (MOLST)
Download: Adobe PDF
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