Suggested health care directive form

A health care directive may include provisions consistent with this chapter, including: 1. The designation of one or more alternate agents to act if the named agent is not reasonably available to serve; 2. Directions to joint agents regarding the process or standards by which the agents are to reach a health care decision for the principal, and a statement whether joint agents may act independently of one another; 3. Limitations, if any, on the right of the agent or any alternate agents to receive, review, obtain copies of, and consent to the disclosure of the principal's medical records; 4. Limitations, if any, on the nomination of the agent as guardian under chapter 30.1-28; 5. A document of gift for the purpose of making an anatomical gift, as set forth in chapter 23-06.6 or an amendment to, revocation of, or refusal to make an anatomical gift; 6. Limitations, if any, regarding the effect of dissolution or annulment of marriage on the appointment of an agent; 7. Health care instructions regarding artificially administered nutrition or hydration; and 8. The designation of an agent authorized to make health care decisions for the principal even though the principal retains the capacity to make health care decisions.