R432-31-3. Life with Dignity Order Forms  


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  • (1) An individual who desires to execute a Life with Dignity Order must use a form or electronic format approved by the Department. The form may not be altered in layout or style, including font style and size, without the express written permission of the Department.

    (2) Any person, health care provider or health care facility may obtain a form from the Department and, if made available by the Department, from a website established for that purpose.

    (3) A health care provider, licensed health care facility, or EMS provider may act upon a copy of a Life with Dignity Order as if it were the original.