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Other Names: Illinois Living Will Illinois Advance Healthcare Directive Illinois Medical Directive Illinois Advance Medical Directive Illinois Advance Health Care Directive
Illinois Advance Directive document preview

What is an Illinois Advance Directive?

An Illinois Advance Directive is a legal document that outlines your preferences related to health care, such as your acceptance or refusal of medical treatment, and/or the selection of a chosen healthcare decision maker. 
 
The person making an Advance Directive is called the "principal," and the person or organization receiving authority to carry out the principal's wishes is known as the "agent." Suitable for Illinois residents, this free Advance Directive can be used in DuPage County, Lake County, Cook County, and in every other part of the state. Each Illinois Advance Directive from Rocket Lawyer can be tailored for your unique scenario. Making this essential legal document provides a record of your decisions to healthcare facilities, and it will certify that your selected agents have been authorized to make choices for you.

When to use an Illinois Advance Directive:

  • You're making sure your loved ones aren't put in the position of making important end-of-life healthcare decisions for you.
  • You're about to draft a complete estate plan, and want to make sure life-sustaining treatments are covered.

Sample Illinois Advance Directive

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LIVING WILL

and

HEALTH CARE POWER OF ATTORNEY

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

(LIVING WILL)

(HEALTH CARE PROXY)

(LIVING WILL AND HEALTH CARE PROXY)

DECLARATION

and

HEALTH CARE PROXY

LIVING WILL

and

MEDICAL DURABLE POWER OF ATTORNEY

DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE-SUPPORT SYSTEMS

HEALTH CARE INSTRUCTIONS

DOCUMENT CONCERNING THE APPOINTMENT OF A HEALTH CARE REPRESENTATIVE FOR HEALTH CARE DECISIONS

OF

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

and

DESIGNATION OF HEALTH CARE SURROGATE

DECLARATION

and

STATUTORY FORM

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

A LIVING WILL

A Directive to Withhold or to Provide Treatment

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

LIVING WILL DECLARATION

and

COMBINED DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND HEALTH CARE REPRESENTATIVE APPOINTMENT

DECLARATION

and

DESIGNATION OF ADVOCATE FOR HEALTH CARE DECISIONS

HEALTH CARE POWER OF ATTORNEY

DECLARATION OF A DESIRE FOR A NATURAL DEATH

and

HEALTH CARE POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

ADVANCE HEALTH-CARE DIRECTIVE

INSTRUCTIONS FOR HEALTH CARE

and

HEALTH CARE POWER OF ATTORNEY

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION

HEALTH CARE PROXY OF

ADVANCE DIRECTIVE OF

LIVING WILL DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

ADVANCE CARE PLAN

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

ADVANCE DIRECTIVE

and

MEDICAL POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION TO PHYSICIANS

(WISCONSIN LIVING WILL)

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

AND

MEDICAL POWER OF ATTORNEY

 

I. LIVING WILLI. ADVANCE DIRECTIVEI. DECLARATIONI. DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE SUPPORT SYSTEMSI. A LIVING WILL - A DIRECTIVE TO WITHHOLD OR TO PROVIDE TREATMENTI. LIVING WILL DECLARATIONI. HEALTH CARE INSTRUCTIONSI. DECLARATION OF A DESIRE FOR A NATURAL DEATHI. HEALTH CARE DIRECTIVEI. DECLARATION TO PHYSICIANS (WISCONSIN LIVING WILL)Declaration made this ______ day of ____________________, _____. I, , willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare:This is an important legal document known as an advance directive. It is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known because of illness or injury. These wishes are usually based on personal values. In particular, you may want to consider what burdens or hardships of treatment you would be willing to accept for a particular amount of benefit obtained if you were seriously ill. You are encouraged to discuss your values and wishes with your family or chosen spokesperson, as well as your physician. Your physician, other health care providers, or medical institution may provide you with various resources to assist you in completing your advance directive. Brief definitions are listed below and may aid you in your discussions and advance planning. Initial the treatment choices that best reflect your personal preferences. Provide a copy of your directive to your physician, usual hospital, and family or spokesperson. Consider a periodic review of this document. By periodic review, you can best assure that the directive reflects your preferences. I, , being of sound mind, willfully and voluntarily make this Declaration for my care to be followed if I become unable to express my desires directly as a consequence of physical or mental incapacity or disability, regardless of whether this is caused by illness, accident, or other injury. This document is intended to direct all persons who are involved with my care including my relatives, physicians or personal representatives which I have appointed, or which hereafter may be appointed by the courts.
even if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be continued to prolong my life as long as possible within the limits of generally accepted health care standards.

__________ (initial) I have a terminal condition

__________ (initial) or I have an irreversible condition

__________ (initial) or I am in a persistent vegetative state

AND if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

 

TO RECEIVE artificially administered nutrition and hydration (food and fluids).NOT TO RECEIVE artificially administered nutrition and hydration (food and fluids) procedures, except as deemed necessary to provide me with comfort care.However, if at any point it is determined that it is not possible that the fetus could develop to the point of live birth with continued application of life-prolonging procedures, it is my preference that this document be given effect at that point. If life-prolonging procedures will be physically harmful or unreasonably painful to me in a manner that cannot be alleviated by medication, I request that my desire for personal physical comfort be given consideration in determining whether this document shall be effective if I am pregnant. I have discussed these decisions with my physician and have also completed a Physician Orders for Scope of Treatment (POST) from that contains directions that may be more specific than, but are compatible with, this Directive. I hereby approve of those orders and incorporate them herein as if fully set forth. I have not completed a Physician Orders for Scope of Treatment (POST) form. If a POST form is later signed by my physician, then this living will shall be deemed modified to be compatible with the terms of the POST form.

 

I designate , who may be reached at , as my Primary Physician.

 

 

 

 

 

 

 

 

including but NOT including . unless I initial the following line:

 

(YOU MUST DATE AND SIGN THIS LIVING WILL AND DESIGNATION

(YOU MUST DATE AND SIGN THIS DESIGNATION

IN THE PRESENCE OF TWO WITNESSES)

I affirm that this Living Will and Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

I affirm that this Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

 

I designate , who may be reached at , as my Primary Physician.

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this living will by . Further, at least one of us is not a spouse or blood relative of .

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this Living Will and Designation by . I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

 

Date: ______________________________

 

Date: ______________________________

The foregoing instrument was acknowledged before me this _____ day of ____________________, ______ by , who is personally known to me or who has produced ________________________________ as identification.

Before me, a Notary Public (or justice of the peace) in and for said county, personally appeared the above named , ________________________________, and ________________________________, who acknowledged that they did sign the foregoing instrument, and that the same is their free act and deed. In testimony whereof, I have hereunto subscribed my name at ________________________________, this _____ day of ____________________, ______.

This instrument was acknowledged before me on this _____ day of ____________________, ______ by .

On this _____ day of ____________________, ______, before me personally appeared , to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed same as his/her free act and deed.

On this _____ day of ____________________, ______, before me, ________________________________, personally appeared , known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same as for the purposes therein contained.

In witness whereof, I hereunto set my hand and official seal.

 

_________________________________

My commission expires _____________

You should sign this document in the presence of a notary public. You should sign this document in the presence of two witnesses who then sign the document in your presence and in each other's presence. You should sign this document in the presence of a notary public and two witnesses who then sign the document in your presence and in each other's presence.

(your Agent)

You should discuss the document and your wishes with any person you want to designate as an Agent before doing so to assure they agree to act on your behalf.

 

Illinois Advance Directive FAQs

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  • How do I make an Advance Directive in Illinois?

    It is quick and easy to outline your medical wishes using a free Illinois Advance Directive template from Rocket Lawyer:

    1. Make the document - Provide a few details, and we will do the rest
    2. Send or share - Review the document with your healthcare agent(s) or seek legal advice
    3. Sign it - Mandatory or not, witnesses/notarization are recommended

    This solution will often be notably less expensive and less time-consuming than hiring and working with a traditional law firm. If necessary, you can prepare an Advance Directive on behalf of an elderly parent, a spouse, or another relative, and then have them sign it once you've drafted it. Please note that for an Advance Directive to be considered legally valid, the principal must be mentally competent when they sign. In the event that the principal is already incapacitated and unable to make their own decisions, a court-appointed conservatorship generally will be required. When managing this situation, it's important to speak with a lawyer .

  • Who should have an Advance Directive?

    Every adult ought to have an Advance Healthcare Directive (both a Healthcare Power of Attorney and a Living Will) in place. Though it is tough to acknowledge, a day will likely come when you can no longer make medical decisions on your own. Typical circumstances in which it would be useful to make or update your Advance Directive include:

    • You currently live in or are planning to move into an adult care facility
    • You are managing a terminal condition
    • You are getting older or dealing with ongoing health issues
    • You will be undergoing an in-patient procedure that requires anesthesia

    Whether this Illinois Advance Directive is being produced as a result of a change in your health or as part of a long-term plan, notarization and/or witnesses will often help to protect your agent if anyone questions their privileges. Please note that in Illinois a Health Care Declaration is not valid during pregnancy.

  • Do I need an attorney to review my Advance Directive in Illinois?

    Making an Advance Directive is normally easy to do, but you or your agent(s) might still have questions. It will vary depending on whom you ask, but often some attorneys will not even agree to review your document if they did not draft it. A more favorable approach worth consideration is to get help via the Rocket Lawyer On Call® network. With a Premium membership, you will be able to ask for advice from an experienced attorney or send additional legal questions about your Advance Directive. As always, we are here for you.

  • On average, what would it traditionally cost me to make an Advance Directive in Illinois?

    The fees associated with hiring and working with an attorney to produce an Advance Directive could be between two hundred and one thousand dollars, depending on where you are located. Unlike many other websites that you may stumble upon, Rocket Lawyer offers much more than an Advance Directive template. If you ever require help from a lawyer, your Premium membership provides up to a 40% discount when you hire an attorney.

  • Is anything else required after I have made an Illinois Advance Directive?

    Alongside your Advance Directive, there will be a series of recommended actions to take after the document is completed. You also can take any or all of these actions with your PoA: making edits, downloading it as a Word document or PDF file, printing it out, and signing it. Finally, your agent(s), care providers, and other impacted parties should get a copy of your fully executed document.

  • Does an Advance Directive need to be notarized or witnessed in Illinois?

    The specific requirements and restrictions will be different in each state; however, in Illinois, your document generally requires two witnesses. If you are only making a Healthcare Power of Attorney and not a Living Will as part of your Advance Directive, then you only need one witness. Witnesses to your Advance Directive form shouldn't be your attending physician, advanced practice nurse, physician assistant, dentist, podiatric physician, optometrist, psychologist, or any relative of the healthcare professionals listed above. Along the same lines, your witness should also not be the owner or operator (or their relatives) at any healthcare facility where you are a patient. Your spouse or any of your other relatives are also prohibited. As a basic standard, your witnesses will need to be at least age 18, and no witness should also be named as your agent.

Illinois Advance Directive document preview

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