An advance directive form is a legal document that outlines your medical treatment preferences in case you cannot communicate or make decisions independently. A medical directive form allows you to dictate the types of medical care you want — and don’t want — so that your loved ones and healthcare providers can act following your wishes.
An advance directive form PDF provides guidance when you cannot speak for yourself due to serious illness or incapacity. It goes into effect in several situations, including:
Filling out a printable advance directive before you need it provides peace of mind and prevents stressful decision-making for loved ones during critical moments.
A sample advance directive is not only for the elderly or those with serious illnesses. Every adult should consider creating one for several essential reasons:
Prevents family conflict: Family members may disagree over which treatments should be provided or withheld without explicit instructions.
Gives you control over your medical care: It ensures that your treatment preferences are respected, even if you can’t voice them at the time.
Reduces emotional burden on loved ones: Making decisions about end-of-life care can be incredibly stressful for family members. An online advance directive eliminates uncertainty.
Avoids unnecessary or unwanted medical interventions: Doctors may take all possible life-saving measures without clear instructions — even if that’s not what you would have wanted.
Ensures legal clarity: Advance directive for health care form is legally recognized in most states, helping avoid legal disputes over medical decisions.
Creating an advance directive is straightforward with the instructions below.
I, Emily Roberts, an individual having my usual place of living at 789 Maple Avenue, Chicago, IL, (the "Principal") being of sound mind and in full awareness of the significance of this document, hereby execute this Advance Directive Form (the "Directive") to express my healthcare preferences and to appoint a healthcare agent to make medical decisions on my behalf if I am unable to do so.
A Healthcare Agent is a trusted person who will make medical decisions on your behalf if you cannot.
I hereby appoint the following individual(s) as my healthcare agent(s):
Agent’s Name: Michael Carter
Agent’s Address: 452 Sunset Blvd, Los Angeles, CA
Agent’s Phone Number: (310) 555-7890
If the Agent named in this Directive is unable or unwilling to make decisions for me, I designate the following individual as an alternate agent: Sophia Mitchell, having their usual place of living at 500 Oak Street, Boston, MA.
This section allows you to express your healthcare and end-of-life treatment wishes.
I request that all life-sustaining treatments be administered, even if my condition is considered terminal.
Palliative care and pain management: I request palliative care, including pain relief and comfort care, to be provided to the greatest extent possible.
End-of-life wishes: If medically possible, I prefer to receive end-of-life care at home.
Specific wishes: No feeding tube or ventilator if recovery is unlikely.
You may choose to donate your body or organs after death for medical research or transplantation.
I give: My body.
To the following persons or institutions: The hospital or medical research institution Johns Hopkins Medical Center.
For the following purposes: Any purpose authorized by law.
This section confirms the legal jurisdiction of the directive and when it takes effect.
Governing law and dispute resolution: This Directive shall be governed by and interpreted following the laws of the State of Illinois, and any disputes arising out of or in connection with this Directive shall be exclusively resolved by the courts of the State of Illinois.
Effective date: This Directive shall become effective immediately upon my incapacitation. This Directive shall lose effectiveness upon the Principal's death.