Advance Medical Directive Form

What is an Advance Medical Directive?

An Advance Medical Directive (AMD) is a legal document that allows you to designate a Medical Agent to make medical decisions for you in the event you are unable to make decisions for yourself. An AMD also allows you to express some medical treatment and end of life care preferences in the event you become unable to make or communicate those decisions yourself. This document is an important part of healthcare planning and is vital to have in place in preparation for situations where a person is incapacitated due to illness, injury, or cognitive decline.

Who is my Medical Agent?

Your Medical Agent, sometimes referred to as Healthcare Proxy, is the Primary Person(s) or Alternative Person(s) you designate to handle your medical decisions if you are unable to yourself. The alternative person(s) you designate steps into the role if your primary agent is unable or unwilling to act. A second alternative is preferred, but optional. It is important that you communicate your desires to your Medical Agent and Alternative Person(s).

What will my Medical Agent be responsible for?

Responsibilities of your Medical Agent may include:

  • advocating for your wishes if you cannot advocate for yourself;
  • making informed decisions regarding your medical care;
  • communicating with your medical providers;
  • communicating with co-agents or your loved ones;
  • respecting your privacy and confidentiality regarding your medical history, information, and treatment preferences; and
  • acting in good faith with respect to your wishes, preferences, and religious beliefs above their own.

When can my Medical Agent make decisions?

For as long as you can make medical decisions for yourself, you will be in control of all of your medical decisions. Your Medical Agent will only step into this role in situations when you cannot make decisions for yourself . For example, your agent would be able to make medical decisions for you in an emergency if you were under anesthesia in surgery, in a coma after an accident, or in times of cognitive incapacity. If you regain your ability to make medical decisions, your Medical Agent’s authority will cease.

Click Here for the Form

Upon completion of the form, it will be sent via docusign to our Compass Law team.

Our team will complete a conflicts check and send an invoice for our flat rate, and schedule a consultation with an attorney at CLP.

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