Alaska Advance Directive

Information you will need

• End of Life Decisions
• Anatomical Gift at Death
• Principal Name
• Principal Address
• Principal Signature Date
• Agent Name
• Agent Address
• Agent Telephone Number
• Alternate Agent Name
• Alternate Agent Address
• Alternate Agent Telephone Number
• Exceptions
• Immediate Authority
• Permanent Unconsciousness
• Terminal Condition
• Additional Instructions
• Artificial Nutrition and Hydration
• Other Instructions
• Other Wishes
• Conditions or Limitations
• Relief from Pain
• Special Instructions
• Unconsious While Pregnant
• Purpose of Anatomical Gift

…and 26 more fields in the PDF.

Completed by the agent and the principal and the provider.

The form includes 3 signature lines, a notary acknowledgment, a witness section.

The document text refers to the laws of Alaska.