1200 West Mohave Road, Parker, Arizona 85344
Hospital: (928) 669-9201 | Fax: (928) 669-7417
Durable Health Care Power of Attorney
Pre-Hospital Medical Directive
Durable Mental Health Care Power of Attorney
Durable Power of Attorney for Your Financial Affairs
Letter to My Agent (Representative)
Advance DirectivesThis information briefly describes how you may exercise your right to make health care decisions under the law. We hope this information will be helpful to you. You are encouraged to talk with your family, your doctors, and anyone else whose advice and support you value in these matters.
Who has the right to make your health care decisions?You do, if you are able to make and communicate your health care decisions. Your doctors should tell you about the treatment they recommend, other reasonable alternatives, and important medical risks and benefits of that treatment, and the alternatives. You decide what health care, if any, you will or will not accept.
What if you become unable to make or communicate your health care decisions?You can still have some control over these decisions if you have signed an advance directive, such as a health care power of attorney, a living will, or both. A health care provider must note in your medical record whether you have signed an advance directive or have declined to sign one.
What is a health care power of attorney and how do your make one?It is a written statement in which you may name another person to make health care decisions for you. You should discuss your health care wishes with this person. The health care power of attorney must:
State that the person you name can only make health care decisions for you while you are unable to make these decisions, if this is what you want.
Be dated and signed by you.
What else may you include in your health care power of attorney?The health care power of attorney may also:
Include any instructions or guidance about health care you want or do not want including the direction to withhold or withdraw life-sustaining procedures if you are in a "terminal condition."
Name a second person to make these decisions if the first person is unable to do so.
Include signatures of witnesses who saw you sign the power of attorney.
What is a Living Will?A living will is a written statement to your doctors describing the kind of health care you want or don't want if you are ever in a "terminal condition." A patient is in a "terminal condition" if that patient's doctor and a second doctor state in writing that the patient's condition cannot be cured and that the patient will die without life-sustaining procedures. A patient is also in "terminal condition" if that patient is in a permanent vegetative state or an irreversible coma.
What does a Living Will do?A living will may direct doctors to withhold or withdraw or continue life-sustaining procedures if you are in a "terminal condition." For example, a living will can tell your doctors whether you want to be fed or given fluids through tubes if you cannot eat or drink on your own. You can also tell doctors whether to use other specific life-sustaining procedures.
Your doctors will use your living will only if you are in a "terminal condition" and unable to make or communicate your health care decisions. Even if you have a living will, your doctors are permitted to keep you comfortable with medication and other procedures as long as this is what you want.
How do you make a valid living will?Sign and date your living will before two witnesses who must also sign it. Neither witness may be directly involved in your care. In addition, one of the witnesses must not:
Be related to you by blood or marriage.
Have a right to receive any of your estate.
Have a claim against your estate.
Be directly responsible to pay for your medical care.
Must you have a lawyer prepare your advance directive?No. There are local and national organizations that may provide you with information on advance directives, including forms. Be sure that any advance directive that you use is valid under Arizona law.
Who should have a copy of your advance directive?Give a copy of your advance directive to your doctor and to any health care facility upon your admission. If you have a health care power of attorney, give a copy of it to the person you have named in it. You should also keep extra copies for yourself.
Can you change or cancel your advance directive?Yes. If you change or cancel your advance directive, be sure to notify anyone who has a copy of your advance directive.
What if you already have an advance directive?You may want to review it, or have it reviewed, particularly if it has been prepared in another state, to make sure that it is valid under Arizona law.
If you have a living will prepared under Arizona law before September 1991, you should know the law has changed. The law now allows you to refuse food or fluids through tubes if you are in a terminal condition.
Does Arizona law limit what can be done under an advance directive?Arizona law prohibits actions or in-actions which may lead to the injury or death of physically or mentally impaired adults. It is unclear if this law will be applied to health care decision-making processes. It becomes particularly important to have a properly prepared advance directive that sets forth your wishes as to specific treatment you do or do not want.
Please choose the form you want from below and click on it. This will take you to a page that has the printable form on it. Just fill it out per the instructions on each form.