Patient Preferences Templates
Patient Preferences
Welcome to our Patient Preferences
page, where you can find a wide range of documents pertaining to healthcare decision-making and end-of-life care. These documents, also known as advance directives, allow patients to express their wishes and preferences regarding medical treatment when they are no longer able to communicate their choices.Within this collection, you will find various forms and orders specific to different states and provinces. For example, the Advance Directive for Health Care Form in Vermont empowers individuals to outline their healthcare preferences, ensuring that their wishes are respected in case they become unable to make decisions for themselves. Similarly, the Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form in Illinois serves as a tool to facilitate communication between patients, healthcare professionals, and emergency responders, focusing on the patient's preferences for life-sustaining treatments.
In Prince Edward Island, Canada, the Goals of Care Form enables patients to document their healthcare goals and values, providing valuable guidance to healthcare providers and loved ones during critical moments. Maryland's DNR Form B-110 Certification of State of Principal Use allows individuals to request a "Do Not Resuscitate" order, indicating their preference to forego life-saving measures in specific situations. Indiana's State Form 55317 Physician Orders for Scope of Treatment (Post) gives patients the opportunity to express their preferences for treatment options and resuscitation efforts.
These documents collection ensures that your healthcare decisions are respected, and your preferences are taken into account. Whether you are seeking to create an advance care plan, clarify your end-of-life wishes, or communicate your healthcare goals, our Patient Preferences
page provides the tools you need to navigate these important conversations. Take control of your future healthcare decisions and let your voice be heard.Documents:
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This document is used to make decisions about life-sustaining treatment in Utah. It is a directive that ensures individuals receive the desired medical care and maintain their dignity in critical situations.
PDF 
Word
Use this form in the state of Maine for a potential situation when a medical issue leaves you unable to express your wishes about medical treatment.
Use this form in the state of Vermont for a potential situation when a medical issue leaves you unable to express your wishes about medical treatment.
Use this document employed in Michigan to state your wishes in regard to your health care treatment preferences in the event of a possible mental disability.
This document is a Medical Orders for Scope of Treatment form specific to the state of South Dakota. It is used for outlining an individual's preferences for medical treatment, including end-of-life decisions and resuscitation orders.
This Form is used for documenting the goals of care for patients in Prince Edward Island, Canada.
This Form is used for making medical treatment decisions in Illinois. It is available in both English and Spanish versions.
