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The Connecticut Advance Directive is becoming the norm for individuals documenting their medical wishes ahead of time. It unites the medical power of attorney with the living will, giving users a blend of both documents. The medical POA portion of the form provides the option of designating a third (3rd) party to make healthcare decisions on your behalf, whereas the living will section allows you to stipulate your own choices. The principal must provide the agent’s name and establish their desires regarding certain medical procedures to put the arrangement into effect. The legal instrument must then be signed under the observation of two (2) witnesses (it is considered a good measure to additionally acquire the certification of a notary public).
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Laws
Definitions – “Advance health care directive” or “advance directive” means a writing executed in accordance with the provisions of this chapter, including, but not limited to, a living will, or an appointment of health care representative, or both (§ 19a-570(1)).
Signing Requirements – Acknowledgment of two (2) approved witnesses (§ 19a-575a). If the declarant wishes to further strengthen the document’s validity, they may have the witnesses additionally sign an affidavit before a notary public or other authorized individual (§ 19a-578).
Revocation – § 19a-575a
Other Versions (6)
- Version 1
- AARP (Caring Connections)
- Five Wishes (Aging with Dignity)
- Prepare for Your Care
- Stamford Health
- Yale New Haven Health
Connecticut Advance Directive – Version 1
Download: Adobe PDF
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
Stamford Health Version (also available in Spanish/en Español)
Download: Adobe PDF
Information: Adobe PDF
Yale New Haven Health Version (also available in Spanish/en Español)
Download: Adobe PDF
Additional Resources
- Connecticare – Advance Health Care Directives Handout
- Connecticut Attorney General – Your Rights to Make Health Care Decisions
- Connecticut Legal Rights Project – Advance Directive Workbook
- CTLawHelp – Advance Directives and Health Care Planning FAQ
- CTLawHelp – Living Wills and Advance Directives
- Hartford HealthCare – Advance Directives Pamphlet
- National Resource Center on Psychiatric Advance Directives – Connecticut FAQs
Related Forms (5)
- Designation of a Conservator
- DNR Order Form
- Document of Anatomical Gift
- Durable (Financial) Power of Attorney
- MOLST Form
Download: Adobe PDF
Download: Adobe PDF, MS Word (.docx)
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF
Medical Orders for Life Sustaining Treatment (MOLST) Form
Download: Adobe PDF
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