Health Care Directive Form Mn. The English form of the Health Care Directives form is read aloud in English to provide aid to those not fluent in written English. The Minnesota Health Care Directive combines both documents into one simple form.
You can write more detailed health care instructions on additional sheets of paper, or you can use the communication form, "My Health Care Choices," which was designed to help you clarify your wishes.
If I have. named a health care agent, these instructions are to be used by the agent.
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My name is. • To consent or refuse consent to any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a physical or mental condition, including admission to or discharge from a health care facility or. Compared to a DNR order, you can use a POLST form to provide more detail. An advance health care directive mayo clinic number name an advance health care directive note: this form meets the legal requirements for an advance Advance directive for medical / surgical treatment (living will) on completion, give copies to your physician, family members, and healthcare.
