Health Care Directive

The law authorizing the use of the Health Care Directive became effective August 1, 1998. It allows competent adults to appoint someone, called an agent, to make health care treatment decisions for them when they are unable or unwilling to communicate a decision for themselves. It allows the written expressions of preference and instructions to the agent, which the agent must follow. It helps your family and your doctor. It lets them know the kind of health care treatment you want or don't want if you can't speak for yourself.

The law permits but does not require you to name an alternative agent. However, it is a good idea to name an alternative agent since your primary agent may be out of town or ill when needed to make decisions for you.

Any competent person 18 years of age or older can execute a Health Care Directive. Health Care Directives are not only for older persons; they are for people of all ages. If your 18 year-old child was injured, it would enable you to participate in the health care decisions.

The Health Care Directive replaces the living will and allows you to express your wishes concerning life support by artificial means, organ donation and disposition of your body at death.

Please complete the following questionnaire if you would like us to prepare a Health Care Directive for you:

Agent: (If you are married, most people name their spouse.)	Alternative Agent:
*Your Name (required)
*Your Email (required)
Name	Name
Address	Address
Relationship	Relationship
Phone #	Phone #
I wish to donate my organs, tissue, and other body parts when I die. Yes No
I have agreed in another document or on another form to donate my organs when I die. Yes No
I request cremation of my remains. Yes No

Lange Law Firm, P.A.
Highland Bank Building, 5270 West 84th St, Suite 300, Bloomington, Minnesota 55437-1385
Phone: (952) 837-1900, Fax: (952) 835-2236, Email: info@willandtrust.com