Medical Directive

Medical Directive

name another person as agent to make health 

care decisions for you if you are unable to make 

your own decisions. You can also have your 

agent make decisions for you right away, even if 

you are still able to make your own decisions. 

• also name an alternate agent to act for you if 

your first choice is not willing, able or reasonably 

available to make decisions for you. 

Your agent may not be: 

• an operator or employee of a community care 

facility or a residential care facility where you are 

receiving care. 

• your supervising health care provider (the doctor 

managing your care) 

• an employee of the health care institution where 

you are receiving care, unless your agent is 

related to you or is a coworker. 

Your agent may make all health care decisions for 

you, unless you limit the authority of your agent. 

You do not need to limit the authority of your agent. 

If you want to limit the authority of your agent the 

form includes a place where you can limit the 

authority of your agent. 

If you choose not to limit the authority of

Medical Directive

Medical Directive

Medical Directive

Medical Directive

Medical Directive

Medical Directive

Medical Directive

Medical Directive

Medical Directive