What is an Advanced Directive?

An advance directive is a form that tells your family, friends, and healthcare providers what medical care you want, in case you’re too sick or injured to speak for yourself.

Advance Directive Form

Click here to download a copy of the UVA Health Advance Directive Form (PDF).

On this form, you can:

  • Name a person to serve as your decision-maker, or agent
  • Give healthcare instructions

To ensure the legality and use of the form:

  • Sign and date the form
  • Have two witnesses
  • Provide a copy to your healthcare provider or hospital

Note: You may revoke or change your advance directive at any time.

Make Sure to Express Your Wishes

Share your preferences and choices with:

  • Loved ones
  • Healthcare providers
  • Your agent (the person you choose to act on your behalf)

Key resources

Charlottesville Albemarle Youth Opportunity Center
Region Ten Financial/Billing Resources
9-8-8 Lifeline
CSB Directory
Important Updates

Order FREE Safe Storage Devices HERE.