Forms cited in the Manual are available below as PDFs. You may add data to a PDF form on-screen. (View instructions)
- Oral Advance Directive
- Affidavit for Friend or Other Relative as Surrogate Decision Maker
- Surrogate Decision Making: Agreement on Who Will Make Decisions
- Surrogate Consent for Medical Procedure
- Physician's Certification of Incapacity to Make an Informed Decision
- Physician's Certification of Medical Condition
- Physician's Certification That Treatment Would Be Medically Ineffective
- Instructions on Current Life-Sustaining Treatment Options
(Effective April 1, 2008, the "Instructions on Current Life-Sustaining Treatment Options" Form replaced the former "Patient's Plan of Care" Form. 2007 Md. Laws, ch. 70; see also Maryland Attorney General's Health Policy Development Website, http://www.oag.state.md.us/Healthpol/index.htm.)
- Form to Document Refused Offer of Instructions on Current Life-Sustaining Treatment Options
- MIEMSS EMS/DNR Order Form
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