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As long as your alterations are made before it is signed, it is still valid (assuming it has not been altered in such a way that your wishes are unclear).
An advance directive is simply a statement of your medical wishes. As long as it is properly executed and makes clear what you want, it will be valid. There is no legal requirement that it is exactly what's provided by the state.
OK what is the best way to make the alterations? I can download a copy of my state's directive. Should I retype it with the alterations?
There isn't a specific way to do it. If the alterations are significant, it may be easier to retype it. If it is just a few words, you can simply strike them and write in what you want.
To whom should I give the directive?
You may find it easier to retype it, however, to avoid any complications. Most advance directive forms are not very long.
Advance directives provide a clause which allows you to name someone to guide your medical care if necessary. Can I leave this part out?
You can if you want. It will still be valid, but I would strongly encourage you to put a name in.
I want my wishes as stated in the directive carried out. I don't think they would be by anyone I named. Can I word the directive in such a way that the person I name has no choice?
Yes. However, even the most comprehensive advance directive form can't cover every possible scenario. That is why you need to put a name in. However, with the advance directive the physician is obligated to follow your wishes.
My wishes are very simple. I just want to make sure no one can override them if I can't speak for myself in any given medical situation.
That can be accomplished through an advance directive form. They are legally binding.
To whom should I give copies of the directive?
You can give a copy to your health care providers and to the people close to you. Many people keep them with their wills.
How do I make sure a copy is available to health care providers (such as EMT's) in case of a sudden, unexpected emergency where I can't speak for myself and "people close" or my personal doctor is not immediately available?
There is a wallet card available that you can carry, which will alert anyone that you have advance directives. You can get one here:
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