Financial Power of Attorney

Assigns a family member or friend to be responsible for finances if you become unable to manage them as a result of injury or illness.

Medical Power of Attorney

Assigns a family member or friend to make healthcare decisions for you if you become unable to do so as a result of injury or illness. He or she must follow any specific directions you give in
your Living Will.

Living Will

Your instructions regarding end-of-life care, namely whether you want life sustaining treatment if your death becomes imminent, you’re in a permanent vegetative state, or have a terminal illness.

What is your name and address and birthday?




Who do you want to make decisions for you if you can't, in order of preference and what are their phone numbers?







Do you want to be an organ donor?

YesNo

Do you want life sustaining treatment if your death becomes imminent, you are in a permanent vegetative state, or have a terminal illness?

YesNo

Where should we send your documents? We'll also send you information on how to make them official.

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