PLEASE NOTE:
This is a highly important legal document so please research the subject before completing the form.

Things to know about the Advance Directive form:

  • This form enables you to record all aspects of treatment you do not wish to receive under specified circumstances.
  • This is a very important and sensitive topic, so please research it and speak to your loved ones before completing it.
  • To complete this form you must have a witness alongside you, so please choose someone close to you to fill this role.
  • If you wish to nominate a healthcare proxy, please also ensure they are present with you to complete the relevant fields.

Things to know about the process:

  • Once you complete the form, a copy will automatically be sent to your Medical Practice and review by your Doctor.
  • In the following two weeks after this your doctor will contact you to confirm your identity and some of the details in the form.
  • Once these details are confirmed, a copy of the Advance Directive will be permanently attached to your medical records.
  • If you would like a physical copy of the document, simply request this from the Doctor and one will be returned to you.
Advance Directive (Living Will) Form
Please use format day/month/year e.g. 12/05/1979
This is a legally binding form which will come into effect upon submission, please confirm whether you wish to advance with this form.