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Idaho Living Will Form |
The Idaho living will form is a document designed to assist a Principal to prepare in writing, their choices pertaining to their options for end of life care when/if the time comes that they no longer have the ability to communicate their own medical choices in person and on their own. The document will also allow the principal to select specific persons who would assist in overseeing the care that the Principal has specified, and to ensure that the specified care is as the Principal has clearly stated within the document. This document should be witnessed, once completed, by a notary public. This document may be revoked should the Principal feel it necessary.
Laws – 39-4501. et seq. Natural Death Act
How to Write
Step 1 – Download the document – begin by dating the directive in mm/dd/yyyy format:
- Submit the name of the Declarant
- Declarant’s address
- Read the information provided under “A Living Will…”
Step 2 – In the next five (5) boxes there will be statements that will require answers to be responded to by either checking the preceding box or initialing the lines before each selection
- The Principal must read the statements and/or the information in and surrounding each box
- Check or initial the boxes or lines as required according to each individual box
Step 3 – A Durable Power of Attorney for Health Care – The following information, if not properly observed, may void this document, be certain to review and understand the following:
- “None of the following may be designated as your agent:
- (1) your treating health care provider;
- (2) a non-relative employee of your treating health care provider;
- (3) an operator of a community care facility;
- or (4) a non-relative employee of an operator of a community care facility.
- If the agent or an alternate agent designated in this Directive is my spouse, and our marriage is thereafter dissolved, such designation shall be thereupon revoked”
Step 4 – Once the Principal has read and understands these specific instructions, the Principal must designate their attorney in fact/agent to make decisions on their behalf if needed:
- Name of appointee
- Address
- Appointee’s telephone number(s)
Step 5 – Titled Sections – The Principal must carefully review the following titled sections:
- Creation of Durable Power of Attorney for Health Care
- General Statement of Authority Granted
- Statement of Desires, Special Provisions and Limitations
- Additional Information – If the Principal would like to make additional statements and provide additional instructions, enter them into the box provided. If additional pages are required, attach then to the document upon completion
- Inspection and Disclosure of Information Relating to Physical or Mental Health
- Signing Documents, Waivers and Releases
Step 6 – Designation of Alternate Agents – Should the Principal wish, in the event the initial agent is unable or unwilling to serve, this form will allow for assignment of up to three (3) more alternate agents. This may be done by providing the following information per alternate agent:
- Alternate Agents Names
- Addresses
- Telephone numbers
Step 7 – Signature of Principal – Read the information and provide:
- Principal’s Signature
- City and State of Residence
