Illinois Advance Directive Form (Medical POA + Living Will)

An Illinois advance directive is a set of medical directives that convey an individual’s end-of-life wishes and appoint a health care agent to make decisions once the patient, also known as the “principal,” becomes incapacitated. A living will and POLST lets the principal list their end-of-life decisions, while a health care power of attorney allows the patient to designate an agent. Health care surrogates may only assume their role once the patient is no longer of sound mind.

Spanish (Español) Version – Adobe PDF

What’s Included?

• Medical Power of Attorney
• Living Will (Declaration)
• Physician Orders for Life-Sustaining Treatment (POLST)

Laws

• Living Will – 755 ILCS 35
• Medical Power of Attorney – 755 ILCS 45
• Physician Orders for Life-Sustaining Treatment (POLST) – 755 ILCS 40/65

Signing Requirements (755 ILCS 35/3(b)) – Two (2) witnesses.

State Definitions

• Health Care Agent (755 ILCS 45/4-4(e-5)) – “Health care agent” means an individual at least 18 years old designated by the principal to make health care decisions of any type, including, but not limited to, anatomical gift, autopsy, or disposition of remains for and on behalf of the individual.

Versions (4)

AARP

Illinois Department of Public Health

Illinois State Medical Society

Memorial Hospital