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OTHER NAMES Iowa Living Will Iowa Advance Healthcare Directive Iowa Medical Directive Iowa Advance Medical Directive Iowa Advance Health Care Directive

What is an Iowa Advance Directive?

An Iowa Advance Directive (or "Declaration Relating to Use of Life-Sustaining Procedures") is a legal document that outlines your preferences in relation to medical care, such as your request for or refusal of medical treatment, and/or the selection of a trusted healthcare decision maker. 
 
The person making an Advance Directive is called the "principal," and the person or entity gaining permission to carry out the principal's wishes is called the "agent." Suited for residents of Iowa, this free Advance Directive can be used in Linn County, Scott County, Polk County, and in every other county throughout the state. Each Iowa Advance Directive from Rocket Lawyer can be modified to address your unique situation. This document will provide proof of your decisions to medical facilities, and it will certify that your selected representatives have been given the authority to act in your interest when you are not able.

When to use an Iowa 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 Iowa Advance Directive

The terms in your document will update based on the information you provide

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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.

 

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Iowa Advance Directive FAQs

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  • How do I write an Advance Directive in Iowa?

    It's very easy to record your medical preferences using a free Iowa Advance Directive template from Rocket Lawyer:

    1. Make the document - Provide a few simple details, and we will do the rest
    2. Send or share it - Discuss the document with your healthcare agent or ask a lawyer
    3. Sign it - Optional or not, witnesses/notarization are encouraged

    This route is, in most cases, notably more affordable and convenient than finding and hiring a traditional law firm. If needed, you may fill out an Advance Directive on behalf of your spouse, an elderly parent, or another relative, and then help them sign once you've drafted it. Please remember that for an Advance Directive to be accepted as valid, the principal must be an adult who is mentally competent when they sign. In the event that the principal is already incapacitated and unable to make their own decisions, a conservatorship could be required. When managing this situation, it is important for you to talk to a lawyer .

  • Who should have an Advance Directive?

    If you are over 18 years old, you should have an Advance Healthcare Directive (both a Healthcare Power of Attorney and a Living Will) in place. While it can be difficult to think about, there could come a day when you are not able to make medical decisions on your own. Here are a few common occasions in which it would be helpful to make or update your Advance Directive:

    • You currently live in or have plans to move into a community care facility
    • You are managing a terminal condition
    • You are aging or have declining health
    • You will be in the hospital for surgery

    Regardless of whether your Iowa Advance Directive has been created as a result of a change in your health or as part of a forward-looking plan, witnesses and notarization are strongly encouraged for protecting this document and/or your agent if their privileges and authority are questioned by a third party. In Iowa, Advance Directives that contain your medical care preferences are not considered valid during the principal's pregnancy.

  • Do I need to hire a lawyer for my Advance Directive in Iowa?

    Making an Advance Directive is typically simple to do, but you or your agent(s) may have questions. Having a lawyer look over the document can take a long time if you do it alone. Another approach might be through attorney services at Rocket Lawyer. Rocket Lawyer Premium members have the ability to request feedback from an attorney with relevant experience or send other questions. As always, you can Live Confidently® knowing that Rocket Lawyer is by your side.

  • What might I normally pay to make an Advance Directive in Iowa?

    The cost of hiring a traditional legal provider to make an Advance Directive could be anywhere between $200 and $1,000, depending on where you are located. Different from other Advance Directive template providers that you may discover, Rocket Lawyer offers Premium membership holders up to 40% in savings when hiring a lawyer, so an attorney from our network can assess the situation and take action if you ever need assistance.

  • Am I required to do anything else after I have made an Iowa Advance Directive?

    With a Rocket Lawyer membership, you can edit it, download it as a PDF document or Word file, and print it out. To make the Iowa Medical Directive into a true legal document, you will need to sign it. You will need to send a final copy of the fully signed document to your agent(s) and care providers.

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

    The guidelines and restrictions for Advance Directives are different by state; however, in Iowa, your Advance Directive needs to be acknowledged by a notary public or signed by two witnesses. The witnesses to your Advance Directive form shouldn't be your healthcare provider or their employees. Only one of the witnesses may be a relative (including your spouse or any adopted children). As a basic principle, witnesses must not be under the age of 18, and none of them should simultaneously be acting as your agent.

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