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State of Oklahoma

Advance Directive for Health Care
This form is available in English, Spanish and Vietnamese at okdhs.org/programsandservices/aging/legal.

If I am incapable of making an informed decision regarding my health care, I direct my health care
providers to follow my instructions below.

I. Living Will
If my attending physician and another physician determine that I am no longer able to make
decisions regarding my medical treatment, I direct my attending physician and other health care
providers, pursuant to the Oklahoma Advance Directive Act, to follow my instructions as set forth
below:
1. If I have a terminal condition, that is, an incurable and irreversible condition that even with the
administration of life-sustaining treatment will, in the opinion of the attending physician and another
physician, result in death within six (6) months:
(Initial one option only)
_____ I direct that my life not be extended by life-sustaining treatment, except that if I
am unable to take