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

What is an Ohio Advance Directive?

An Ohio Advance Directive (or "Declaration Governing Life-Sustaining Treatment") is a legal document that sets forth your preferences with regard to health care, such as your refusal of or request for a certain medical treatment, and/or the naming of a chosen healthcare agent. 
 
The person making an Advance Directive is known as the "principal," and the individuals or organizations receiving authority to carry out the principal's wishes are called "agents." Designed for Ohio residents, this free Advance Directive is made for use in Hamilton County, Summit County, Cuyahoga County, and in all other counties throughout the state. Any Ohio Advance Directive from Rocket Lawyer can be fully customized for your unique circumstances. As a result of having this official document, your medical providers will have a point of reference for your preferences, and your representative can offer proof that they have been authorized to act in your interest when you are not able.

When to use an Ohio 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 Ohio 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.

 

Ohio Advance Directive FAQs

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  • How do I write an Advance Directive in Ohio?

    It is quick and easy to set forth your medical preferences using a free Ohio Advance Directive template from Rocket Lawyer:

    1. Make your Advance Directive - Answer a few questions, and we will do the rest
    2. Send or share - Look over it with your healthcare agent or get legal help
    3. Sign and make it legal - Required or not, witnesses and notarization are a best practice

    This route is, in many cases, much less expensive and less time-consuming than meeting and hiring a conventional provider. If needed, you can start an Advance Directive on behalf of your spouse or another relative, and then have them sign it once you've drafted it. Keep in mind that for an Advance Directive to be accepted as legally valid, the principal must be mentally competent at the time of signing. If the principal is already unable to make their own decisions, a conservatorship generally will be required. When facing such a scenario, it's a good idea to speak to an attorney .

  • Why should I write an Advance Directive?

    Anyone who is over 18 years old ought to have an Advance Healthcare Directive (both a Healthcare Power of Attorney and a Living Will). Although it is difficult to acknowledge, there might come a day when you are not able to make your own medical decisions. Here are some typical occasions in which it may be useful to make or update your Advance Directive:

    • You are expecting to undergo an in-patient procedure requiring anesthesia
    • You are aging or dealing with ongoing health issues
    • You've been given a terminal diagnosis
    • You live in or are planning to move into an adult care facility

    Regardless of whether your Ohio Advance Directive has been produced in response to a recent change in your health or as part of a long-term plan, witnesses and notarization can help to protect your document if someone challenges its validity. In Ohio, Advance Directives in the form of a Living Will are considered invalid during pregnancy, unless the pregnancy will not develop to a live birth.

  • Do I need a lawyer for my Advance Directive in Ohio?

    Making an Advance Directive is normally simple, but you or your agent might have questions. Finding an attorney to proofread your Ohio Advance Directive may be costly. A more cost-effective alternative would be via the Rocket Lawyer attorney network. By signing up for a Premium membership, you can get your documents reviewed or ask any legal questions. As always, you can rest assured that Rocket Lawyer will be by your side.

  • How much might I traditionally need to pay for an attorney to help me make an Advance Directive in Ohio?

    The fees associated with working with an attorney to make an Advance Directive might range anywhere between $200 and $1,000. Unlike the other websites you might stumble upon, Rocket Lawyer offers more than an Advance Directive template. If you ever require help from a lawyer, your Rocket Lawyer membership offers up to a 40% discount when you hire an Rocket Lawyer network attorney.

  • Will I have to do anything else after making an Ohio Advance Directive?

    Upon finishing your Advance Directive with the help of Rocket Lawyer, you will have the ability to retrieve it from your account wherever and whenever you choose. You should feel free to engage with the document in one or all of the following ways: editing it, downloading it in PDF format or as a Word document, printing it, and signing it. Attached to each Ohio Advance Directive, there will be a series of helpful tips to follow while finalizing your document. You will need to send a copy of your fully signed document to your agent(s) and care providers.

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

    The rules will vary in each state; however, in Ohio, your document must be signed by a notary public or two witnesses. Witnesses to this Advance Directive cannot be your attending physician or an administrator of the nursing home where you reside, nor your spouse, adoptee, or other relative. As a basic rule, your witnesses should be 18 years old or older, and none of them should also be named as your agent.

Ohio Advance Directive document preview

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