Trauma Survivors Network - provided by ATS

Survive. Connect. Rebuild.

A Program of the ATS

Advance Medical Directive Example

Here is an example of an Advance Medical Directive. It is a real one. It happens to have been prepared (and signed) by a 36-year-old woman who lives in the State of Texas. Points 1-6 (below) are, as required, in accord with the Texas Health Code. Point 7 was added to specify further her wishes.

Remember that this is just an example. Your Advance Medical Directive should reflect your own personal wishes.

Please go to the example here: Advance Medical Directive

Associated pages

Do-Not-Resuscitate Order (DNR)