Washington Advance Directive Form (Medical POA & Living Will)

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The Washington Advance Directive serves to publish an arrangement to confirm a person’s decisions for medical treatment preferences and appointment of a designated attorney-in-fact within the same document. The form standardizes a space to record the options an individual wishes to institute for health care choices should they become unconscious or comatose and can no longer communicate their desired selections. Included in the paperwork’s contents is the medical power of attorney to indicate an appointed agent to make decisions on the principal’s behalf and a living will to determine their requested basic health care alternatives. The living will portion aids in verifying the course of action to be taken in cases where the patient would require resuscitation, surgery, medication, or a blood transfusion according to the declarant’s needs. The signing of the registry will necessitate the assistance of two (2) witnesses that have no relation by blood or marriage to the principal and do not stand to gain from the estate of the individual. In addition, the execution of the filing will need to be overseen and sanctioned by a notary public endorsement.

Other Versions (8)

AARP (Caring Connections) Version

Download: Adobe PDF
Instructions: Adobe PDF

 

 

 


Compassion & Choices of Washington Version

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Instructions: Adobe PDF

 

 

 


Everplans Washington Version

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Five Wishes (Aging with Dignity) Version 

Download: Adobe PDF
Information: Adobe PDF

 

 

 


Honoring Choices Washington Version

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Kaiser Permanente Version

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

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Washington State Medical Association Version 

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Additional Resources

Related Forms (4)

Advance Directive for Mental Health

DownloadAdobe PDF, MS Word (.docx)
Instructions: Adobe PDF

 

 

 


Advance Directive Wallet Card

Download: Adobe PDF

 

 

 


Durable (Financial) Power of Attorney

Download: Adobe PDF, MS Word (.docx)

 

 

 


POLST (Physician Orders for Life-Sustaining Treatment) Form

Download: Adobe PDF