The Alaska Advance Directive, which is a form that combines a medical power of attorney and a living will, lets a resident choose a health care proxy and make decisions related to end-of-life treatment options. To implement this form, the principal party will have to designate an agent that they trust, select their desired options, and sign the instrument either in front of two (2) eligible witnesses or an individual who possesses the ability to notarize the document.
This document contains the following sections:
- Part I: Durable Power of Attorney for Health Care Decisions
- Part II: Instructions for Health Care
- Part III: Anatomical Gift at Death
- Part IV: Mental Health Treatment
- Part V: Primary Physician
Laws
Statutes – Alaska Statutes – Health Care Decisions Act (§ 13.52.010 – 13.52.025)
Definition – “Advance health care directive” means an individual instruction or a durable power of attorney for health care (§ 13-52-390(1)).
Signing Requirements – A licensed notary public or two (2) witnesses must oversee the event to provide a valid record of acceptance of all necessary endorsements (§ 13.52.010(b)).
Revocation – § 13.52.020
Other Versions (6)
- AARP (Caring Connections)
- ANTHC Version
- Five Wishes (Aging with Dignity)
- Lifecare Directives Version
- Prepare for Your Care
- Providence St. Joseph Health
AARP (Caring Connections) Version
Download: Adobe PDF
Instructions: Adobe PDF
Alaska Native Tribal Health Consortium Version
Download: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Download: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Providence St. Joseph Health Version (also available in Spanish/en Español)
Download: Adobe PDF
Information: Adobe PDF
Additional Resources
- Alaska Law Help – Alaska Advance Health Care Directive
- Alaska Law Help – Completing a Power of Attorney
- Alaska Native Tribal Health Consortium – Advance Care Planning Conservation Guide
- Alaska Native Tribal Health Consortium – Advance Planning Brochure
- Alaska State Medical Association – POLST Patient Guide
- Providence St. Joseph Health – Advance Directive Multimedia Library
- Sitka Community Hospital – Advance Directive
Related Forms (4)
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- Mental Health Care Advance Directive
- POLST Form
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF
Mental Health Care Advance Directive Form
Download: Adobe PDF
Physician Orders for Life-Sustaining Treatment (POLST) Form
Download: Adobe PDF
Comments