How do I make out the advance directive form?
Complete the following steps:

• Read the entire form completely and make sure you understand what it says.
• Decide how you wish to fill it out.
• Decide if you will have it notarized by a notary public or signed by two witnesses. Our PrimeWise office will notarize your Advance Directive form for FREE. Simply call us at 859-301-5999 for more information.
• Understand you must be 18 years of age or older.
• Complete the form in the presence of either a notary public or two witnesses. Make sure that you check and initial all the lines that you would like to apply to you, and date and sign the form. Depending on availability, the medical center will attempt to provide services of a notary public to notarize your signature on this form.

Be aware that the following persons may not be witnesses:

• a blood relative
• an heir to your estate
• an employee of a health care facility where you are receiving care (an employee may sign as a notary public but not a witness)
• your doctor
• or any person who must pay for your health care

Q. What should I do with my advance directive once I have completed it?
A. Keep the original in a safe place, but do not lock it away where you or your family may not be able to get to it if you need it in an emergency. Make sure that family members and/or close friends and your surrogate(s) have copies and discuss it with them. Ask for a copy of "Talking with Others About Advance Directives" by calling PrimeWise at 859-301-5999 or e-mail your request to: primewise@stelizabeth.com. You should also give a copy to your doctor and discuss it with him or her. Our PrimeWise department will be happy to notarize your form. Simply contact them to arrange this FREE service.

You will be asked if you have an advance directive each time you are admitted to the hospital or another facility. This is required by federal law. You need to bring a copy of your advance directive, if you have one, to the hospital each time you are admitted. This policy protects you by making sure the hospital has your most current advance directive.

Q. Where can I get help in understanding this advance directive?
A. A good place to start is by talking to your doctor, The St. Elizabeth PrimeWise staff (301-5999); or if you are an inpatient, your nurse or the social service staff.