Advance Directives printable pdf download

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Advance Directives

What is an Advance Directive?

Advance Directives are written instructions a person completes that tell medical providers what to do if

they become incapacitated and can’t make those decisions for themselves. For example, a person might

not want to be placed on life support if they are in an accident or have a stroke or other serious medical

event. Any competent adult in Colorado (age 18+) can obtain an Advance Directive.

Advance directives help you to:

 Protect your right to make medical decisions about your healthcare

 Help family Members make decisions if you are not able to

 Help your providers by telling them your wishes

Why do I need an Advance Directive?

Federal Medicaid regulations (CMS-2104-F, Section 438.6(i)(1) and Colorado State law CRS 15-18.101-

113) recognize the right of competent adults to make decisions regarding their medical care, including

their right to accept or reject medical treatment. These laws further require organizations to ask you if you

have an Advance Directive. You do not have to have an Advance Directive to receive services from any

provider. Advance directives say what kind of medical care you want if you get too sick or hurt to talk or

think clearly. The State of Colorado gives you the right to have an advance directive if you are 18 or

older

There are four (4) kinds of advance directives:

1. Living Will: A Living Will tells your doctor whether to use artificial life support (medical help) if

you become “terminally ill” (sick enough that you are expected to die). Copies of Living Will

forms are at healthcare facilities, providers’ offices, and office supply stores. You can also get

them at the Guardianship Alliance of Colorado by calling:

(303) 228-5382.

2. Durable Power of Attorney: A durable power of attorney is a person you choose to make

healthcare choices for you if you cannot speak for yourself.

3. CPR Orders/Do Not Resuscitate (DNR) Order: CPR Orders/DNR order allows you to choose how

to instruct medical staff on performing life saving measures if your heart stops beating and/ or you

stop breathing on your own. For example, you may tell them to not perform CPR.

4. Proxy Decision Maker for Medical Treatment: A proxy decision maker for medical treatment can

make decisions on your behalf if you are unable to make an informed consent, refusal, or

discontinuation of medical treatment.

If you want to obtain additional information on advance directives visit:

If you have an Advance Directive it is your responsibility to provide a copy of the document to any

organization you are seeking medical/behavioral health services at the time of intake or as soon as

possible following your intake. The document will then be placed in a prominent location in your medical

record. If you ever revoke or change your Advance Directive, you must inform your care coordinator as

soon as possible so your information can be updated in your medical record.

Advance Directives