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You are encouraged to send a copy of your combined form to the west virginia e directive registry.

Combined living will and medical power of attorney. Should you become unable to understand make or communicate decisions about medical care your wishes for. Combined living will health care power of attorney example form from pennsylvania act 169 of 2006 part i introductory remarks on health care decision making you have the right to decide the type of health care you want. There are two basic documents that allow you to set out your wishes for medical care. 20 i hereby insert your name and address appoint as my representative to act on my behalf to give withhold or withdraw informed consent to health care decisions in the event that i am not able to do so myself.

A complete listing of all frequently asked questions relating to the combined living will medical power of attorney can be found by clicking on the faqs link on this page. A living will and a durable power of attorney for health care. The representative may not choose any end of life decisions unless the principal specifically writes in that he or she would like that as an option. In some states the living will and the power of attorney are combined into a single form often called an advance directive.

This one document combines both the living will and medical power of attorney documents and should be used if you want to name a health care decision maker and do not want machines and other medical interventions to keep you alive when you are dying or permanently unconscious. A living will lets a person establish end of life plans without the use of a surrogate to help guide medical staff as to their wishes. A medical health care power of attorney allows an individual to give someone else the right to make decisions about their end of life treatment options while guiding their intentions in the form. It s wise to prepare both.

A photo copy of your combined form is legally valid. Combined medical power of attorney and living will dated. Medical power of attorney allows a person to handle someone else s health care decisions only in the chance that he or she may not be able to think for themselves.

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