Download Advance Directive Form in: Word or PDF

What is a mental health advance directive?

A mental health advance directive is a written document that describes what you want to happen if you become so incapacitated by mental illness that your judgment is impaired and/or you are unable to communicate effectively. It can inform others about what treatment you want or don't want, and it can identify a person to whom you have given the authority to make decisions on your behalf.

How do I complete a mental health advance directive?

A model "fill-in-the-blanks" form was included in the state law and it is probably the best and easiest way to create a mental health advance directive. You can download the form, or contact the Ombuds for a form, or your mental health provider may also have copies of the form.

Does my provider have to follow what I say?

The law requires mental health providers to respect your mental health advance directive, but they are not required to follow it in all cases. If instructions or preferences in your mental health advance directive are against hospital policy or are unavailable, or would violate state or federal law or immediately endanger you or others, providers are not obligated to comply with those provisions. Also, if you are involuntarily hospitalized under the Involuntary Treatment Act, or are incarcerated in jail, your mental health advance directive may not be fully honored.

If you would like further assistance with understanding and filling out your advance directive you can contact the Mental Health Ombuds at (360) 867-2556 or (800) 658-4105.