Georgia Advance Directive for Healthcare (ADHC)
The Department of Human Resources Division of Aging Services (DAS) informed Georgians that as of July 1, 2007, the new Georgia Advance Directive for Healthcare has replaced the Georgia laws on the Living Will and the Durable Power of Attorney for Healthcare. This replacement document combines the characteristics of both the Living Will and the Durable Power of Attorney for Healthcare and still allows people to choose the medical care they want when they are no longer able to communicate with doctors or family. Those persons who already have Living Wills and/or Durable Powers of Attorney for Healthcare are allowed to keep the forms that they have, and they are still legally binding until they are revoked. The Durable Power of Attorney for Healthcare was repealed or removed from the law, and the Living Will law was completely rewritten and replaced (Division of Aging Services, 2016).
ADVANCE DIRECTIVE ACKNOWLEDGEMENT
Advance Directive Information for this patient:
- Advance Directive for Healthcare Yes_____ No_____
- Living Will Yes_____ No_____
- Do Not Resuscitate (DNR) Form Yes_____ No_____
- Durable Power of Attorney for Health Care Yes_____ No_____
Name:_________________________________________ Phone:_____________________________
I hereby acknowledge and understand the above statement.
Patient Signature _______________________________ Date ____________ Time ___________
Witness Signature_______________________________ Date ____________ Time ___________
FOR OFFICE USE ONLY
- Advance Directive Placed on Chart Yes_____ No_____
- Patient / Family to Bring Yes_____ No_____
- Patient / Family Requests Information Yes_____ No_____
- GA Advance Healthcare Directive and/or Pamphlet Given Yes_____ No_____
- Report given to _______________________________ (Nurse) regarding Advance Directive Information
Reviewed 02/11/2022, Revised 11/2015, 10/2018, 03/06/2019, 12/6/2019, 08/12/2025
