Forms

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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• Save the form to your local hard drive by clicking "File," then "Save."
• Open the saved PDF in Adobe Acrobat.
• Place your cursor in the appropriate form fields and type your data. If you have difficulty locating a form field, press the tab key.

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