Health Care Directive
Adults have the right to make choices about their health care. No treatments may be given to you if you
do not want them.
The attached Durable Power of Attorney for Health Care form is a legal health care directive document,
developed to meet the requirements of Iowa Code Chapters 144A and 144B. It allows you to appoint
another person and alternate persons to make your health care decisions if you become unable. The
person you ask to make health care choices for you is your health care agent.
This document gives your agent the authority to make health care decisions for you only if:
you are unable to communicate your wishes and health care decisions due to illness or injury,
health care providers have determined that you are not able to make your own health care
This form does not give your agent permission to make your financial or other business decisions. As
stated by Iowa law, “health care” means any care, treatment, service, or procedures to maintain,
diagnose, or treat your physical or mental condition.
Take the time to read this form carefully before you complete it. You can list in this form the types of
health care you do and do not want. You can limit the types of choices your health care agent can make.
It is very important that you discuss your views, values, and this document with your health care agent.
If you do not closely involve your agent, your views and values may not be fully respected because they
may not be understood.
What if I decide not to complete a Durable Power of Attorney for Health Care form?
You do not have to sign a Durable Power of Attorney for Health Care form. Doctors, insurance providers,
or non-profit hospitals cannot force you to have this type of form to receive their services. Under Iowa
Code Chapter 144B, your life insurance cannot be canceled if your health care is being withdrawn or
withheld according to your wishes in this form.