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The Tennessee Advance Directive provides a legally enforceable arrangement for an individual to denote their preferences for future health treatment. The form is a common measure to put in place as a precaution should an unforeseen event occur, rendering one to enter an incapacitated state. Also recorded in the agreement is a section to nominate an attorney-in-fact to be issued as an authority to make health care decisions for the principal party. Consideration for an individual’s wishes can be indicated concerning the following possible quality of life conditions or treatments:
- CPR
- Tube-Feeding
- Dialysis
- Life-Support
- Comatose Condition
- End-of-Life Care
- Hospice Care
- Organ Donation
Finalizing the contract will require all endorsements to be performed in the presence of a notary public of two (2) witnessed approved by the Tennessee Code Annotated § 68-11-1803(b) that states each witness cannot be:
“related to the principal by blood, marriage, or adoption and would not be entitled to any portion of the estate of the principal upon the death of the principal under any will or codicil made by the principal existing at the time of execution of the advance directive or by operation of law then existing.”
Laws
Statute – Tennessee Health Care Decisions Act ( § 68-11-1801 – § 68-11-1815)
Definitions – “Advance directive” means an individual instruction or a written statement relating to the subsequent provision of health care for the individual, including, but not limited to, a living will or a durable power of attorney for health care (§ 68-11-1802).
Signing Requirements – State regulation stipulates that a notary must be present to verify the signing of the document or two (2) viable witnesses (§ 68-11-1803(b)).
Revocation – (§ 68-11-1804)
Other Versions (5)
- AARP (Caring Connections)
- Five Wishes (Aging with Dignity)
- Prepare for Your Care
- Spanish Version
- Vanderbilt University Medical Center
AARP (Caring Connections) Version
Download: Adobe PDF
Instructions: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Download: Adobe PDF
Vanderbilt University Medical Center Version (also available in Spanish/en Español)
Download: Adobe PDF
Additional Resources
- Elder Law of East Tennessee – Your Advance Directive: A Gift to Your Loved Ones
- Help4TN.org – Advance Medical Directives & Health Care Agents
- Honoring Choices Tennessee – Upload, Share, and Access an Advance Directive
- Honoring Choices Tennessee – Why Do I Need an Advance Directive?
- Middle Tennessee ENT Specialists – Care at the End of Life
- Middle Tennessee ENT Specialists – Planning to Be an Organ Donor
- Tennessee Bar Association – Health Care Directives for Seniors
- Tennessee Department of Health – Advance Directives for Health Care Decision Making (also available in Spanish/en Español)
- Tennessee Department of Health – FAQ’s: Physician Order for Scope of Treatment
- Tennessee Department of Health – FAQ’s: Provider Identification of a Surrogate Form
- Tennessee End-of-Life Partnership – FAQ’s for Understanding Advance Directives
- University of Tennessee – Advance Directives Fact Sheet
Related Forms (5)
- Declaration for Mental Health Treatment
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- POST Form
- Provider Identification of Surrogate
Declaration for Mental Health Treatment
Download: Adobe PDF
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
POST (Physician Orders for Scope of Treatment) Form 
(also available in Spanish/en Español)
Download: Adobe PDF
Provider Identification of Surrogate 
(also available in Spanish/en Español)
Download: Adobe PDF
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