Georgia Advanced Directive Page 24
Download a blank fillable Georgia Advanced Directive in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Georgia Advanced Directive with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29Try to extend my life for as long as possible
(A) _________ (Initials)
, using
all medications, machines, or other medical procedures that in reasonable
medical judgment could keep me alive. If I am unable to take nutrition or
fluids by mouth, then I want to receive nutrition or fluids by tube or other
medical means.
OR
Allow my natural death to occur.
(B) _________ (Initials)
I do not want any
medications, machines, or other medical procedures that in reasonable
medical judgment could keep me alive but cannot cure me. I do not want to
receive nutrition or fluids by tube or other medical means except as needed
to provide pain medication.
OR
(C) _________ (Initials) I do not want any medications, machines, or other
medical procedures that in reasonable medical judgment could keep me
alive but cannot cure me, except as follows:
[Initial each statement that you want to apply to option (C).]
_________ (Initials) If I am unable to take nutrition by mouth, I want to
receive nutrition by tube or other medical means.
_________ (Initials) If I am unable to take fluids by mouth, I want to receive
fluids by tube or other medical means.
_________ (Initials) If I need assistance to breathe, I want to have a
ventilator used.
Page 10 of 15
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Medical