Home > Legal > Will and Trust Template > Advance Directive Template > Colorado Advance Directive Form > Colorado Advance Medical Directive Form 3

Colorado Advance Medical Directive Form 3

At Speedy Template, You can download Colorado Advance Medical Directive Form 3 . There are a few ways to find the forms or templates you need. You can choose forms in your state, use search feature to find the related forms. At the end of each page, there is "Download" button for the forms you are looking form if the forms don't display properly on the page, the Word or Excel or PDF files should give you a better reivew of the page.

Colorado Advance Medical Directive Form 3 Page 2
Colorado Advance Medical Directive Form 3
a physician; 2) the declarant’s physician or an employee of his/her physician; 3)an employee or a
patient of the health care facility in which the declarant is a patient; or 4) a beneficiary or creditor of
the estate of the declarant.
Dated at_______________, Colorado, this______ day of ___________, in the year_______.
_______________________________________ ______________________________________
(Signature of Witness) (Signature of Witness)
Address:_______________________________ Address:________________________________
______________________________________ _______________________________________
OPTIONAL
STATE OF COLORADO, County of ___________________________
Subscribed and sworn to or affirmed before me by ____________________, the declarant, and
_____________________ , and ______________________________, witnesses, as the voluntary
act and deed of the declarant, this ______________ day of __________________, in the year
___________.
My commission expires: ___________________________________________
Notary Public
In Summary
Federal law directs that any time you are admitted to any health care facility, or served by
certain organizations that receive Medicare of Medicaid money, you must be told about
Colorado’s laws concerning your right to make health care decisions.
Upon admission, you must be given information about advance directives.
Although you have the right to make an advance directive, you cannot be required to have or
make an advance directive in order to be admitted to a health care facility or to receive
treatment or care.
Talk to your doctor about medical conditions which might make advance directives useful.
Talk with your health care providers about your wishes and beliefs. Make sure that copies of
your advance directives are included in your medical records. It is your responsibility to
provide these copies to your health care providers.
You must be given written information about your health care providers’ policies and
procedures regarding your advance directives. Be sure to discuss whether your directive
swill be honored. If you determine their policies are not consistent with your advance
directives, you may wish to transfer to another facility or provider.
If you do not want your family and closer friends to select a substitute decision maker
(proxy) to make medical decisions for you, you should have an advance medical directive
such as a medical durable power of attorney in which you name the person who will make
decisions for you.
Colorado Advance Medical Directive Form 3