|Any time you present to a hospital registration area or become a patient, Iowa law requires we ask every patient age 18 and over whether or not they have an advance directive. Advance Directives are legal documents that make your medical wishes known, in the event that you are unable to do so yourself. |
Iowa law provides two types of advance directives: Living Will and Durable Power of Attorney. See your attorney if you are interested in setting up one or both of these documents. Information and tools are also available at our Health Information Department or you may download and complete the form below:
Advance Directives for Healthcare (printable form)
A Living Will is a document directing your healthcare provider that certain life-sustaining procedures should be withheld if you are in a terminal condition and unable to decide for yourself. This allows you to state your wishes in writing, but does not name an agent. It takes effect when you have a terminal condition and are unable to make decisions.
Durable Power of Attorney
A Durable Power of Attorney allows you to name anyone at least eighteen years old, known as your "agent", to make healthcare decisions for you, in the event you are unable to do so yourself. This agent is required to make decisions according to directions you may provide in the durable power document or otherwise. It goes into effect only when you are not able to make decisions for yourself.
What if I already have a Living Will or Durable Power of Attorney?
If you already have these documents, it is strongly encouraged that you bring a copy to RMC to keep on file with your medical records. This ensures they are available in the event of an emergency and your medical wishes are known to hospital staff. This form is also required if requesting medical records.
What do I do once the form is completed?
Keep original in your possession
Send a copy to:
- Your Power of Attorney designee
- HIS Department (for any RMC or RFH providers)
RMC Fax: 563-927-7348
RFH Fax: 563-927-7988
RMC and RFH: email@example.com
- Healthcare Providers outside RMC or RFH