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Alaska Advance Health Care Directive Form 2

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Alaska Advance Health Care Directive Form 2
ADVANCE HEALTH CARE DIRECTIVE
Explanation
You have the right to give instructions about your own health
care. You also have the right to name someone else to make health
care decisions for you. This form lets you do either or both of these
things. It also lets you express your wishes regarding the designation
of your health care provider. If you use this form, you may complete or
modify all or any part of it. You are free to use a different form if the
form contains the substance of this form or otherwise complies with the
requirements of AS 13.52.
Part 1 of this form is a durable power of attorney for health
care. Part 1 lets you name another individual as an agent to make
health care decisions for you if you become incapable of making your
own decisions or if you want someone else to make those decisions for
you now even though you are still capable. You may name an alternate
agent to act for you if your first choice is not willing, able, or
reasonably available to make decisions for you. Unless related to you,
your agent may not be an owner, operator, or employee of a health care
institution where you are receiving care.
Unless the form you sign limits the authority of your agent,
your agent may make all health care decisions for you. This form has a
place for you to limit the authority of your agent. You do not have to
limit the authority of your agent if you wish to rely on your agent for all
health care decisions that may have to be made. If you choose not to
limit the authority of your agent, your agent will have the right to
(a) consent or refuse consent to any care, treatment, service, or
procedure to maintain, diagnose, or otherwise affect a physical or
mental condition, including the administration or discontinuation of
psychotropic medication;
(b) select or discharge health care providers and institutions;
Alaska Advance Health Care Directive Form 2
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