Arkansas Living Will & Durable Power of Attorney for Health Care Form

The Arkansas Living Will & Durable Power of Attorney for Health Care declare two parts the first being a Living will where you may declare that if you suffer from an incurable or irreversible health condition you wish to withhold or withdraw the treatment. The second part is where you appoint an Attorney-in-fact to make Health related decisions on your behalf if you are not capable of making those decisions.

How to Fill the Arkansas Living Will & Durable Power of Attorney for Health Care Form

The form begins with a declaration of living will wherein the name of the principal needs to be stated. This declaration certifies and directs the doctor or physician the withdrawal of the treatment which extends the process of dying in case of any untreatable or irreversible medical condition; it also certifies that if the principal becomes permanently unconscious then in that case to withdraw all the life-supporting treatments that may prolong the dying process or which are not benefiting in any way. Below the same a list of life-sustaining treatments are mentioned out-of which the ones which need to be withdrawn need to be chosen and if there are any other directives then they also need to be stated.

In the second section, an undertaking confirming the withdrawal of Artificial Nutrition and Hydration after consulting the concerned physician needs to be named, dated and signed by the principal followed by the name, address and signature of two witnesses.

In the third and the last section, a declaration to assign a durable power of attorney for health care beginning with the name of the declarant followed by the appointed attorney or agent has the complete authority to take decisions on their behalf when the principal is not in a state physically or mentally to make the same related to only health care matters and shall be considered equal to theirs. These decisions hold no barriers and or limitations and would be taken in the best interest of the declarant and if required after consulting the concerned physician. A successor’s name also needs to be stated who would act when due to any reason if the primary agent is not able or available to take the decision. This power does not have a end date and ends only after the demise of the principal or if the principal voluntarily ends the same. The document ends with the date and signature of the declarant followed by the name, address and signatures of two witnesses.

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Arkansas Advance Directive for Health Care Form

Preview Arkansas Living Will & Durable Power of Attorney for Health Care Form

Arkansas Living Will & Durable Power of Attorney for Health Care Form