The Indiana Advance Directive (Medical POA & Living Will) is a multi-functional form that gives its executors the opportunity to declare their wishes regarding life-ending care as well as appoint a representative to handle certain medical decisions on their behalf. More and more states are adopting this format as it makes it easier for the public to convey their wishes in one cohesive document. If this appeals to you, you will need to make sure to transcribe the details of both parties within the instrument, indicate your choices regarding healthcare, and sign the form corresponding with Indiana law (signing requirements listed below).
This Document Contains:
To register as an organ donor within the state, visit the Donate Life Indiana website to begin the process.
Laws
Statute – Medical POA (§ 16-36-1), Living Will (§ 16-36-4)
Definition – A “representative” is an individual at least eighteen (18) years of age appointed to consent to the health care of another under this chapter (§ 16-36-1-2). A “living will declarant” means a person who has executed a living will declaration under Section 10 of this chapter (§ 16-36-4-3).
Signing Requirements – The appointment of a health care representative requires at least one (1) adult witness (§ 16-36-1-6(a)(3)), whereas the execution of a living will demands two (2) witnessing parties (§ 16-36-4-8(b)(5)).
Other Versions (4)
Download: Adobe PDF
Instructions: Adobe PDF
Indiana Catholic Conference Version
Download: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Download: Adobe PDF
Additional Resources
- Goshen Health – Approaching End of Life
- Indiana Catholic Conference – A Guide to Health Care Directives
- Indiana Geriatrics Society – Understanding POST
- Indiana State Department of Health – Advance Directive Information
- Indiana State Department of Health – POST Information for Healthcare Professionals
- Indiana State Department of Health – POST Form Information for Patients
- Reid Health – Advance Directive Checklist
- Reid Health – Advance Directive FAQ
- Reid Health – Deciding Together Toolkit
- VA Health Care – Advance Directive Brochure
Related Forms (5)
- DNR Order (Form 49559)
- Durable (Financial) Power of Attorney
- Life-Prolonging Procedures Declaration (Form 55315)
- Organ Donation Form
- Physician Orders for Scope of Treatment – POST (Form 55317)
DNR Order (Form 49559)
Download: Adobe PDF
Laws: § 16-36-5
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Life-Prolonging Procedures Declaration (Form 55315)
Download: Adobe PDF, MS Word (.docx)
IUH Version: Adobe PDF
Spanish Version: Adobe PDF
Laws: § 16-36-4-11
Download: Adobe PDF
Physician Orders for Scope of Treatment – POST (Form 55317)
Download: Adobe PDF, MS Word (.docx)
Laws: § 16-36-6
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