Idaho Living Will Form (Advance Directive)

The Idaho Living Will And Durable Power Of Attorney For Health Care will provide a means of choosing the type of health care they receive when they are no longer able to themselves through illness. This can include coma and brain damage or even the end of the principal’s life if the situation should arise. State law dictates that only the principal is to sign. However, it is recommended to seek witnesses or a notary. § 39-4510

How to Write

Living Will & Durable Power OF Attorney

Directive

Principal must enter their personal details.

  • Date.
  • Name.
  • Address.

 

Provision Of Life Continuing Treatment

User must select whether or not to have treatment to prolong life.

  • Check box and initial to have life prolonging treatment provided.
  • Check box and initial to withhold or withdraw life prolonging treatment.
  • (A) Check box and initial to have only hydration provided.
  • (B) Check box and initial to have only nutrition provided.
  • (C) Check box and initial to have both hydration and nutrition provided.
  • Check box to withhold or withdraw all life prolonging treatment.

 

Affirmation Of Details For Prolonging Of Life

Principal must declare whether or not the statements regarding prolonging of life are full and final.

  • Check box and initial to make decisions regarding prolonging of life full and final.
  • Check box to declare that modifications to decisions for prolonging life may be made at later times via use of a POST form.

 

Designation Of Health Care Agent

1) Enter personal details of designated agent.

  • Name.
  • Address.
  • Telephone number.

 

Special Provisions And Limitations

4) The principal Must enter details of any special provisions and limitations regarding treatments to prolong life.

 

Designation Of Alternative Agents

7) Personal details of alternative agents must be entered.

  • Name.
  • Address.
  • Telephone number.

 

Prior Designations Revoked

8) Principal must sign and enter their address if they wish to revoke any prior Durable Power Of Attorney For Health Care.