Massachusetts Health Decisions

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New England States Forms

You can download info on various advance directives and other materials from the New England states here.  Click any link below to open the PDF in your browser. You can then read it, or download it to your computer using the “Save” or “Save As” buttons provided in most browsers.  For the Massachusetts Health Care Proxy, in English and other languages, and other publications on the Proxy, visit our Forms page.

State Advance Directive Forms & Information

Connecticut – Combined Forms

Maine – Advance Health Care Directive Form

Maine – Facts about Health Care Advance Directives

Massachusetts Health Care Proxy: Forms in English and 15 additional languages

Massachusetts Health Care Proxy Law – M.G.L. 201D

Massachusetts Health Care Proxy & ‘Rogers v Commissioner of the MA Dept of Mental Health’ – Barbara Anthony to Alex Moschella 1997

New Hampshire – Advance Care Planning Guide

New Jersey – Proxy_Directive

New York – Planning Your Health Care in Advance

Rhode Island – Durable Power of Atty for Health Care

Rhode Island – Living Will

Vermont – Advance Directive-Long Form

Vermont – Advance Directive-Short Form

Vermont – Appoint an Agent Form

Veterans Health Administration – Combined Advance Directive

 

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About the Massachusetts Health Care Proxy and Massachusetts Health Decisions

Wow, that Health Care Proxy is so user friendly and easy. Thank you. I actually have the form because my husband was in the hospital last week and it made us realize we need to do one of these. Thanks again for the help.
B.L., Lynn, MA

Wonderful! Thanks for being so prompt and efficient.
D.C., Purchasing - Buyer, Lynn Community Health Center

Thanks so much for putting the info in the mail to me and for including the Values History. It looks like a good thing to work with. Having just been involved in putting things in order after the death of my little brother, I know how many loose ends there are and this is helpful. Thanks, as well, for suggesting I may want a closer health proxy than my relative in California. She promises to get right on a plane if I need her to and I can't think of anyone closer. I will work on that, though...
S.M., Somerville

“'If the patient hasn’t designated anyone in a Health Care Proxy, the physician may suddenly be put in the position of being a family mediator. The physician doesn’t want to do it, doesn’t have time to do it, and it’s not good for patient care,' says David Clarke, director of Massachusetts Health Decisions."
Vital Signs: The Monthly Member Publication of the Massachusetts Medical Society, “End-of-Life Care: How and Who Decides,” June/July 1997.

“‘You don’t want someone as your agent who’s going to be faint-hearted,’ Clarke told his audience. ‘If you’re the one lying on the hospital bed and you’re hurt and unable to speak for yourself, you want someone who’s going to be your knight in shining armor. . .and that may be a son or daughter, or it may not.’"
The Enterprise, ‘Raynham seniors hear discussion on health care proxy,’ June 28, 1994.

Thanks so much for your quick reply. Yes, please send the invoice to my attention but the order to D.S. It is always a pleasure dealing with you – so efficient! I wish all my vendors were so easy to work with.
C.S., Emerald Physicians, Hyannis

Thank you so very very much for taking the time with me the other day. Also, THANK YOU for plunging further into this interesting world to find the right solutions for my family and our Massachusetts college-bound son. I am grateful for your careful summary and the Health Care Proxy attachment. Sometimes in this world we light on the very right source of knowledge and guidance - not often!! I am grateful we connected! I will look over your email and proceed now more wisely.
C.M., Shavertown, PA

Questions?

If you have questions about the Health Care Proxy, about grants through Health Decisions Resources, or the work of Massachusetts Health Decisions, please don't hesitate to contact us.

American Health Decisions

American Health Decisions (AHD) is a national coalition of citizens' groups concerned about ethical issues in health care. AHD is a non-profit, non-partisan organization that helps people understand health care choices, articulate the values that shape them, and participate in the health policy process. AHD organizations work to empower individuals to participate fully in personal choices affecting their own health care. Find Out More

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