Use these links to download an advance directive form and instructions.
•Download Adobe PDF form here (Version for visually impaired here) •Download Microsoft Word (.docx) form here (Version for visually impaired here)
•Download Adobe PDF form here (Version for visually impaired here)
•Download Microsoft Word (.docx) form here (Version for visually impaired here)
(Firefox users: If these links do not open when you click on them, please right click on the link and select "Open in new tab.")
The form may now be filled out on your computer and printed. You can use it to make health care choices. If you prefer, we can mail you one copy. Email your request for a printed copy to firstname.lastname@example.org, call 410-576-7000, or write to the Office of the Attorney General, Health Decisions Policy Division, 300 W. Preston Street, 3rd floor, Baltimore, MD 21201. This is a free service, limited to one copy only; however, you are welcome to make as many copies yourself as you want.
This form is optional. No one is required to fill it out, and other forms may be used and are just as valid legally. For example, a widely praised form called "Five Wishes" is available (for a small fee) from the non-profit organization Aging With Dignity. Advance directives from a variety of religious perspectives are available here.
You can also download a printer-friendly version of Maryland's “Advance Directive Information Sheet." Click here to download a PDF copy of the information sheet.
To obtain information about a Physician's Order form that allows emergency medical personnel to provide comfort care instead of aggressive interventions (a MOLST or “EMS/DNR Order"), call the Maryland Institute for Emergency Medical Services Systems at 410-706-4367. You can also download the form from marylandmolst.org.
The Maryland Department of Health makes available an advance directive focused on preferences about mental health treatment. Click here for a copy of the Advance Directive for Mental Health Treatment.
If you've made an advance directive, you should consider carrying a wallet card saying so. The Office of the Attorney General has developed a wallet card for your use. This card alerts healthcare workers that you have an advance directive and provides contact names and numbers. Simply print, then fill out the card and carry it in your wallet (click here for a printer-friendly version of the card).
As a public service, the American Hospital Association also makes a wallet card available through their website. Click here to download a copy of the AHA's “Put It in Writing" wallet card.
Everyone has the right to make personal decisions about health care. Doctors ask whether you will accept a treatment by discussing the risks and benefits and working with you to decide. But what if you can no longer make your own decisions? Anyone can wind up hurt or sick and unable to make decisions about medical treatments. An advance directive speaks for you if you are unable to, and helps make sure your religious and personal beliefs will be respected. It's a useful legal document for an adult of any age to plan for future health care needs. While no one is required to have an advance directive, it's smart to think ahead and make a plan now. If you don't have an advance directive—and later you can't speak for yourself—usually your next of kin will then make health care decisions for you. But even if you want your next of kin to make decisions for you, an advance directive can make things easier for your loved ones by helping to prevent misunderstandings or arguments about your care.
What can you do in an advance directive?
An advance directive allows you to decide who you want to make health care decisions for you if you are unable to do so yourself. You can also use it to say what kinds of treatments you do or don't want, especially the treatments often used in a medical emergency or near the end of a person's life.
Health Care Agent. Someone you name to make decisions about your health care is called a “health care agent" (sometimes also called a “durable power of attorney for health care," but, unlike other powers of attorney, this is not about money). You can name a family member or someone else. This person has the authority to see that doctors and other health care providers give you the type of care you want, and that they do not give you treatment against your wishes. Pick someone you trust to make these kinds of serious decisions and talk to this person, to make sure they understand and is willing to accept this responsibility.
Guidance for health care agents and surrogate decision makers is available in the handbook "Making Medical Decisions for Someone Else: A Guide for Marylanders." Click here for a PDF copy of this handbook. A brochure about this handbook is available here.
Health Care Instructions. You can let providers know what treatments you want to have or don't want to have. (Sometimes this is called a “living will," but it has nothing to do with an ordinary will about property.) Examples of the types of treatment you might decide about are:
a. Life support, such as breathing with a ventilatorb. Efforts to revive a stopped heart or breathing (CPR)c. Feeding through tubes inserted into the bodyd. Medicine for pain relief
a. Life support, such as breathing with a ventilator
b. Efforts to revive a stopped heart or breathing (CPR)
c. Feeding through tubes inserted into the body
d. Medicine for pain relief
Ask your doctor for more information about these treatments. Think about how, if you become badly injured or seriously ill, treatments like these fit in with your goals, beliefs, and values.
Begin by talking things over, if you want, with family members, close friends, your doctor, or a religious advisor. Many people go to a lawyer to have an advance directive prepared. You can also obtain sample forms (see below, “Where can you get forms and more information about advance directives?"). There is no one form that must be used. You can even make up your own advance directive document.To make your advance directive valid, it must be signed by you in the physical or electronic presence of two witnesses, who will also sign. If you name a health care agent, make sure that person is not a witness. Maryland law does not require the document to be notarized. You should give a copy of your advance directive to your doctor, who will keep it in your medical file, and to others you trust to have it available when needed. Copies are just as valid as the originals.
You can also make a valid advance directive by talking to your doctor in front of a witness.
Usually, your advance directive would take effect when your doctor certifies in writing that you are not capable of making a decision about your care. If your advance directive contains health care instructions, they will take effect depending on your medical condition at the time. If you name a health care agent, you should make clear in the advance directive when you want the agent to be able to make decisions for you.
Yes, you can change or take back your advance directive at any time. The most recent one will count.
Using an electronic advance directive is not required; however, electronic forms allow you to create, update, and share your information with health care providers at any time. In 2018, Maryland developed a program to recognize electronic advance directive services (companies) that meet strict online standards. This program allows health care providers to directly link to your electronic advance directive, if needed, when you create an electronic advance directive through one of these services. You do not need to pay to have your electronic advance directives honored or used by medical staff taking care of you.
There are many places to get forms, including medical, religious, aging assistance, and legal organizations. Three places are shown below, but these are just examples. Any of these forms are valid in Maryland, but not all may be in keeping with your beliefs and values. Your advance directive does not have to be on any particular form. There are many places to get forms, including medical, religious, aging assistance, and legal organizations. Three places are shown below, but these are just examples. Any of these forms are valid in Maryland, but not all may be in keeping with your beliefs and values. Your advance directive does not have to be on any particular form.
Maryland Office of the Attorney General
410-576-7000 or 1-888-743-0023.
National Hospice and Palliative Care Organization (NHPCO)
Aging with Dignity
The Montgomery County Palliative Care and End of Life Coalition provides links to advance directive forms in languages other than English: ADVANCE CARE PLANNING | MC PC EOL Coalition (mccelc.org)
The Office of the Attorney General has created an informational presentation on advance care planning and advance directives. Download the PowerPoint presentation here .
200 St. Paul Place, Baltimore, MD 21202
410-576-6300 / En español 410-230-1712 / 1-888-743-0023 toll-free / TTY: Dial 7-1-1 or 800-735-2258