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Other Names: Rhode Island Living Will Rhode Island Advance Healthcare Directive Rhode Island Medical Directive Rhode Island Advance Medical Directive Rhode Island Advance Health Care Directive
Rhode Island Advance Directive document preview

What is a Rhode Island Advance Directive?

A Rhode Island Advance Directive is a legal document that lays out your preferences related to health care, such as your refusal or acceptance of certain medical treatments or procedures, and/or your selection of a trusted healthcare decision maker. 
 
The individual making an Advance Directive is called the "principal," and the people or organizations receiving authority to carry out the principal's wishes are known as "agents." Suitable for residents of Rhode Island, this free Advance Directive is made for use in Kent County, Washington County, Providence County, and in all other counties across the state. Any Rhode Island Advance Directive from Rocket Lawyer can be edited to address your specific scenario. With this essential document on hand, your healthcare providers will have a point of reference for your preferences, and your representative(s) can offer confirmation that they have been given the authority to act in your interest when you are not able.

When to use a Rhode Island Advance Directive:

  • You're making sure your loved ones aren't put in the position of making important end-of-life healthcare decisions for you.
  • You're about to draft a complete estate plan, and want to make sure life-sustaining treatments are covered.

Sample Rhode Island Advance Directive

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LIVING WILL

and

HEALTH CARE POWER OF ATTORNEY

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

(LIVING WILL)

(HEALTH CARE PROXY)

(LIVING WILL AND HEALTH CARE PROXY)

DECLARATION

and

HEALTH CARE PROXY

LIVING WILL

and

MEDICAL DURABLE POWER OF ATTORNEY

DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE-SUPPORT SYSTEMS

HEALTH CARE INSTRUCTIONS

DOCUMENT CONCERNING THE APPOINTMENT OF A HEALTH CARE REPRESENTATIVE FOR HEALTH CARE DECISIONS

OF

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

and

DESIGNATION OF HEALTH CARE SURROGATE

DECLARATION

and

STATUTORY FORM

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

A LIVING WILL

A Directive to Withhold or to Provide Treatment

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

LIVING WILL DECLARATION

and

COMBINED DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND HEALTH CARE REPRESENTATIVE APPOINTMENT

DECLARATION

and

DESIGNATION OF ADVOCATE FOR HEALTH CARE DECISIONS

HEALTH CARE POWER OF ATTORNEY

DECLARATION OF A DESIRE FOR A NATURAL DEATH

and

HEALTH CARE POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

ADVANCE HEALTH-CARE DIRECTIVE

INSTRUCTIONS FOR HEALTH CARE

and

HEALTH CARE POWER OF ATTORNEY

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION

HEALTH CARE PROXY OF

ADVANCE DIRECTIVE OF

LIVING WILL DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

ADVANCE CARE PLAN

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

ADVANCE DIRECTIVE

and

MEDICAL POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION TO PHYSICIANS

(WISCONSIN LIVING WILL)

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

AND

MEDICAL POWER OF ATTORNEY

 

I. LIVING WILLI. ADVANCE DIRECTIVEI. DECLARATIONI. DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE SUPPORT SYSTEMSI. A LIVING WILL - A DIRECTIVE TO WITHHOLD OR TO PROVIDE TREATMENTI. LIVING WILL DECLARATIONI. HEALTH CARE INSTRUCTIONSI. DECLARATION OF A DESIRE FOR A NATURAL DEATHI. HEALTH CARE DIRECTIVEI. DECLARATION TO PHYSICIANS (WISCONSIN LIVING WILL)Declaration made this ______ day of ____________________, _____. I, , willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare:This is an important legal document known as an advance directive. It is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known because of illness or injury. These wishes are usually based on personal values. In particular, you may want to consider what burdens or hardships of treatment you would be willing to accept for a particular amount of benefit obtained if you were seriously ill. You are encouraged to discuss your values and wishes with your family or chosen spokesperson, as well as your physician. Your physician, other health care providers, or medical institution may provide you with various resources to assist you in completing your advance directive. Brief definitions are listed below and may aid you in your discussions and advance planning. Initial the treatment choices that best reflect your personal preferences. Provide a copy of your directive to your physician, usual hospital, and family or spokesperson. Consider a periodic review of this document. By periodic review, you can best assure that the directive reflects your preferences. I, , being of sound mind, willfully and voluntarily make this Declaration for my care to be followed if I become unable to express my desires directly as a consequence of physical or mental incapacity or disability, regardless of whether this is caused by illness, accident, or other injury. This document is intended to direct all persons who are involved with my care including my relatives, physicians or personal representatives which I have appointed, or which hereafter may be appointed by the courts.
even if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be continued to prolong my life as long as possible within the limits of generally accepted health care standards.

__________ (initial) I have a terminal condition

__________ (initial) or I have an irreversible condition

__________ (initial) or I am in a persistent vegetative state

AND if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

 

TO RECEIVE artificially administered nutrition and hydration (food and fluids).NOT TO RECEIVE artificially administered nutrition and hydration (food and fluids) procedures, except as deemed necessary to provide me with comfort care.However, if at any point it is determined that it is not possible that the fetus could develop to the point of live birth with continued application of life-prolonging procedures, it is my preference that this document be given effect at that point. If life-prolonging procedures will be physically harmful or unreasonably painful to me in a manner that cannot be alleviated by medication, I request that my desire for personal physical comfort be given consideration in determining whether this document shall be effective if I am pregnant. I have discussed these decisions with my physician and have also completed a Physician Orders for Scope of Treatment (POST) from that contains directions that may be more specific than, but are compatible with, this Directive. I hereby approve of those orders and incorporate them herein as if fully set forth. I have not completed a Physician Orders for Scope of Treatment (POST) form. If a POST form is later signed by my physician, then this living will shall be deemed modified to be compatible with the terms of the POST form.

 

I designate , who may be reached at , as my Primary Physician.

 

 

 

 

 

 

 

 

including but NOT including . unless I initial the following line:

 

(YOU MUST DATE AND SIGN THIS LIVING WILL AND DESIGNATION

(YOU MUST DATE AND SIGN THIS DESIGNATION

IN THE PRESENCE OF TWO WITNESSES)

I affirm that this Living Will and Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

I affirm that this Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

 

I designate , who may be reached at , as my Primary Physician.

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this living will by . Further, at least one of us is not a spouse or blood relative of .

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this Living Will and Designation by . I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

 

Date: ______________________________

 

Date: ______________________________

The foregoing instrument was acknowledged before me this _____ day of ____________________, ______ by , who is personally known to me or who has produced ________________________________ as identification.

Before me, a Notary Public (or justice of the peace) in and for said county, personally appeared the above named , ________________________________, and ________________________________, who acknowledged that they did sign the foregoing instrument, and that the same is their free act and deed. In testimony whereof, I have hereunto subscribed my name at ________________________________, this _____ day of ____________________, ______.

This instrument was acknowledged before me on this _____ day of ____________________, ______ by .

On this _____ day of ____________________, ______, before me personally appeared , to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed same as his/her free act and deed.

On this _____ day of ____________________, ______, before me, ________________________________, personally appeared , known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same as for the purposes therein contained.

In witness whereof, I hereunto set my hand and official seal.

 

_________________________________

My commission expires _____________

You should sign this document in the presence of a notary public. You should sign this document in the presence of two witnesses who then sign the document in your presence and in each other's presence. You should sign this document in the presence of a notary public and two witnesses who then sign the document in your presence and in each other's presence.

(your Agent)

You should discuss the document and your wishes with any person you want to designate as an Agent before doing so to assure they agree to act on your behalf.

 

Rhode Island Advance Directive FAQs

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  • How do I write an Advance Directive in Rhode Island?

    It's fast and simple to outline your medical wishes with a free Rhode Island Advance Directive template from Rocket Lawyer:

    1. Make the document - Provide a few details, and we will do the rest
    2. Send or share - Look over it with your healthcare agent(s) or ask a legal question
    3. Sign it and make it legal - Required or not, witnesses and notarization are a best practice

    This route is often notably less time-consuming than hiring and working with the average law firm. If needed, you can fill out an Advance Directive on behalf of an elderly parent, a spouse, or another family member, and then have that person sign it once you've drafted it. Please note that for this document to be valid, the principal must be mentally competent when they sign. If the principal is already unable to make their own decisions, a court-appointed conservatorship could be required. When facing such a scenario, it is best for you to talk to an attorney .

  • Do I need to write an Advance Directive?

    Every person over 18 should have an Advance Healthcare Directive (both a Living Will and a Healthcare Power of Attorney). Even though it's unpleasant to acknowledge, there could come a day when you cannot make important decisions on your own. Typical circumstances in which it would be helpful to make or update your Advance Directive include:

    • You plan to undergo a medical procedure requiring anesthesia
    • You are aging or dealing with ongoing health issues
    • You have been diagnosed with a terminal illness
    • You intend to move into an adult care facility

    Whether your Rhode Island Advance Directive is being generated as part of a forward-looking plan or produced as a result of a recent change in your health, notarization and/or witnesses often help to protect your agent if their privileges and authority are challenged by a third party. Please note that in Rhode Island, Advance Directives in the form of a Living Will are not valid if the principal is pregnant and the fetus could develop for a live birth.

  • Should I hire an attorney to review my Advance Directive in Rhode Island?

    Making an Advance Directive is generally simple, but you might need advice. Finding someone to check your document may take a long time if you attempt to do it alone. An alternate approach to consider is to get help via Rocket Lawyer attorney services. Rocket Lawyer members are able to ask for feedback from an experienced lawyer or ask additional legal questions. As always, you can Live Confidently® with Rocket Lawyer by your side.

  • What would I usually need to pay for an attorney to help me make an Advance Directive in Rhode Island?

    The cost of meeting and hiring a lawyer to make an Advance Directive might add up to anywhere between two hundred and one thousand dollars. Different from many other sites you may come across, Rocket Lawyer offers much more than an Advance Directive template. If you ever require assistance from a lawyer, your membership offers up to a 40% discount when you hire an Rocket Lawyer network attorney.

  • Is anything else required after I make my Rhode Island Advance Directive?

    With a Premium membership, you can edit it, download it as a PDF document or Word file, or print it. To make your Rhode Island Medical Directive legally binding, you must sign it. You will need to provide a copy of your fully signed document to your agent(s), care providers, and other impacted parties.

  • Does an Advance Directive need to be notarized or witnessed in Rhode Island?

    The specifications and restrictions for Advance Directives will vary in each state; however, in Rhode Island, your Advance Directive usually needs to be signed by two witnesses. If you are only making a Healthcare Power of Attorney and not a Living Will as part of your Advance Directive, then you may have it notarized instead of finding two witnesses. Witnesses shouldn't include your healthcare provider or their employee, nor should they be the owners, operators, or employees of your community care facility. Only one of the witnesses may be legally related to you (such as a spouse, adopted child, or family member) or any other heir/beneficiary. As a general principle, witnesses must not be under 18 years old, and none should also be designated as your healthcare agent.

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