What Forms Will I Need?
Ensuring Your Wishes Are Met
Once you have chosen your healthcare champion and talked with him or her about your treatment preferences, it’s time to put your decisions in writing.
Follow the steps below to document your wishes:
An advance directive (Health Care Power of Attorney and/or Living Will) is a legal document about your wishes for medical treatment that is used when you are not able to make your own medical decisions. You can use an advance directive to name someone to speak for you and to make your wishes known.
The documents and their requirements are different depending on the state you are in. Forms are available to print from this site. A Novant Health team member can help you complete your document at no cost to you. Please speak to your medical provider about completing these forms.
Create the legal documents needed to honor your choices. Consider which ones are right for you:
For North Carolina residents
- NC Easy-to-read Advance Directive (Health Care Power of Attorney and Living Will)
- NC Easy-to-read Advance Directive - Spanish version (Health Care Power of Attorney and Living Will)
- NC Medical Orders for Scope of Treatment (MOST) form
- NC Advance Instruction for Mental Health Treatment
For South Carolina residents
Taking the next steps
Once you have completed these documents, there are a few steps to take to be sure your choices are honored by your providers and those who are important to you:
- Download and print out the Next Steps document (PDF) or Spanish version (PDF), for future reference.
- Give a copy to your provider. It is very important that your advance directives get added to your medical record. If you send a copy of your directives by mail. Be sure to include a copy of the Medical Record AD Entry form or a cover letter with your address, date of birth and contact information.
- Discuss your choices with your provider(s). Tell your healthcare provider what your wishes are. Make sure you are both clear on what you want and that your wishes will be honored.
- Give a copy of your document(s) to your healthcare agent if you have one. This is the person you named in your Health Care Power of Attorney.
- Give copies to your family and those who are important to you. You might also want to give a copy to your clergy.
- Keep the original document(s) where they will be safe and easy to obtain. Make an extra copy for yourself in case you lose your original or it is accidentally destroyed or damaged. Do not put these documents in a safe deposit box.
- Label one copy "Hospital" and take it with you if you are admitted to a hospital. Tell the hospital staff to make a copy of the document and return your copy to you.
- Make a list of everyone to whom you gave a copy of your document(s). If you ever change your documents, you will have a list of who needs updated copies.
- Upload documents on your smartphone. Consider uploading a copy of your advance directives onto your smartphone.
- Download and print out the My Champion Wallet Card flyer in English or in Spanish and carry it with you.