Nevada Advance Health-Care Directive
(Living Will & Durable Power of Attorney for Health-Care Decisions)
[“Directive”]

[// GUIDANCE: This form is designed to comply with Nev. Rev. Stat. §§ 162A.700 et seq. (Durable Power of Attorney for Health-Care Decisions) and §§ 449.535 et seq. (Directive Relating to the Withholding or Withdrawal of Life-Sustaining Treatment). Replace bracketed text, delete guidance comments, and review all substantive choices with the client.]

TABLE OF CONTENTS

I. Document Header.......................................................1
II. Definitions...........................................................2
III. Operative Provisions..................................................3
IV. Representations & Warranties..........................................6
V. Covenants & Restrictions..............................................6
VI. Default & Remedies....................................................7
VII. Risk Allocation.......................................................8
VIII. Dispute Resolution...................................................9
IX. General Provisions...................................................10
X. Execution Block......................................................11
Attachment A – Revocation of Directive..................................14

I. DOCUMENT HEADER

1. Title; Declarant.
   This Nevada Advance Health-Care Directive (“Directive”) is executed by [FULL LEGAL NAME OF DECLARANT] (“Declarant”), residing at [ADDRESS], date of birth [MM/DD/YYYY].

2. Recitals.
   A. Declarant is of sound mind and desires to make written advance instructions regarding health-care decisions, including the appointment of an agent.
   B. Declarant executes this Directive pursuant to, and in conformity with, Nev. Rev. Stat. §§ 162A.700 et seq. and §§ 449.535 et seq.
   C. Declarant intends that health-care providers act in reliance upon this Directive and be protected from liability when acting in good faith.

3. Effective Date; Duration.
   This Directive becomes effective upon execution and remains in effect until revoked in accordance with Section IX.2.

4. Governing Law.
   This Directive shall be governed by and construed in accordance with the laws of the State of Nevada.

II. DEFINITIONS

For purposes of this Directive, capitalized terms have the meanings set forth below; terms defined in statutes have the same meaning herein.

“Agent” means the person designated in Section III.1 to make health-care decisions on Declarant’s behalf when Declarant is incapable.

“Alternate Agent” means the person(s) designated in Section III.1(c) to act if the primary Agent is unavailable, unwilling, or disqualified.

“Artificial Nutrition and Hydration” means invasive provision of nutrients or fluids through feeding tube, IV, or similar medical technology.

“Comfort Care” means any measure taken to alleviate pain or maintain comfort, including palliative and hospice care.

“Health-Care Decision” has the meaning assigned in NRS 162A.760.

“Incapacity” means a determination by the attending physician or other qualified professional that Declarant lacks the ability to understand and appreciate the nature and consequences of health-care decisions.

“Life-Sustaining Treatment” means any mechanical or artificial medical procedure that sustains, restores, or substitutes a vital function and would, if withdrawn, result in or accelerate death.

“Provider” means any physician, hospital, or other health-care institution or professional providing care to Declarant.

III. OPERATIVE PROVISIONS

1. Appointment of Health-Care Agent.
   a. Primary Agent. Declarant appoints [PRIMARY AGENT NAME], whose address is [ADDRESS] and phone [PHONE], as Agent.
   b. Scope of Authority. Agent is authorized to make any and all health-care decisions the Declarant could make, consistent with this Directive, including but not limited to:
   i. Consent to, refuse, or withdraw any treatment, service, or procedure;
   ii. Employ and discharge Providers;
   iii. Receive and disclose medical information under HIPAA;
   iv. Authorize admission to or discharge from health-care facilities;
   v. Make anatomical gift decisions under Section III.3.
   c. Alternate Agent(s). If the Agent is unable or unwilling to act, the following persons, in the order named, shall serve:
   1) [ALTERNATE AGENT 1 NAME, ADDRESS, PHONE];
   2) [ALTERNATE AGENT 2 NAME, ADDRESS, PHONE].

2. Health-Care Instructions.
   a. End-of-Life Decisions. If I am diagnosed with an incurable and irreversible condition that will result in my death within a relatively short time, or if I am in a state of permanent unconsciousness, my wishes are:
   [ ] I DIRECT that life-sustaining treatment be WITHHELD or WITHDRAWN.
   [ ] I DIRECT that life-sustaining treatment be PROVIDED.
   [// GUIDANCE: Check or describe desired option; add specific instructions as needed.]
   b. Artificial Nutrition and Hydration.
   [ ] I DO NOT want artificial nutrition and hydration.
   [ ] I DO want artificial nutrition and hydration.
   c. Pain Relief / Comfort Care. I direct that maximum comfort care be provided even if it may hasten death.
   d. Pregnancy. If I am pregnant, I direct that [SPECIFY INSTRUCTIONS OR “AS REQUIRED BY LAW”].
   e. Mental-Health Treatment (Optional). [INCLUDE OR OMIT pursuant to NRS 433A.
   f. Other Instructions. [FREE-FORM TEXT].

3. Anatomical Gifts (Optional).
   [ ] I WISH to make an anatomical gift pursuant to NRS 451.500 et seq. Specify organs/tissues and purposes: [TEXT].
   [ ] I DO NOT wish to make an anatomical gift.

4. HIPAA Authorization.
   Declarant authorizes any covered entity to disclose protected health information to Agent for purposes of carrying out this Directive, consistent with 45 C.F.R. § 164.502.

5. Nomination of Guardian (Optional).
   If a court finds a guardian necessary, Declarant nominates the Agent as guardian of the person.

6. Personal Instructions & Spiritual Preferences (Optional).
   [TEXT]

IV. REPRESENTATIONS & WARRANTIES

1. Capacity. Declarant represents and warrants that Declarant is at least eighteen (18) years old, of sound mind, and not acting under duress or undue influence.

2. Voluntariness. Declarant understands the nature and effect of this Directive and executes it voluntarily.

3. No Conflicts. Declarant affirms that no prior directive inconsistent with this document remains in effect, except as referenced herein.

V. COVENANTS & RESTRICTIONS

1. Agent’s Fiduciary Duties. Agent shall:
   a. Act in good faith and within the scope of authority herein;
   b. Follow Declarant’s expressed wishes and values;
   c. Consult with medical professionals and family when appropriate;
   d. Keep accurate records of decisions.

2. Prohibited Persons. No treating Provider, or employee thereof, may serve as Agent unless related to Declarant by blood, marriage, or adoption.

3. Delegation. Agent may not delegate decision-making authority except as expressly permitted by this Directive or Nevada law.

VI. DEFAULT & REMEDIES

1. Failure or Unavailability of Agent. If no Agent or Alternate Agent is able to act, providers shall follow Declarant’s written instructions herein and, if none, the statutory default hierarchy under NRS 162A.470.

2. Injunctive Relief. Any court of competent jurisdiction in Nevada may issue injunctive relief to enforce this Directive.

3. Attorneys’ Fees. The prevailing party in any action to enforce or interpret this Directive is entitled to reasonable attorneys’ fees and costs.

VII. RISK ALLOCATION

1. Provider Protection; Good-Faith Standard. No Provider acting in good faith reliance on this Directive, and within the scope of applicable law, shall incur civil or criminal liability or be deemed to have engaged in unprofessional conduct. See NRS 162A.­­840.

2. Indemnification of Provider. Declarant (and Declarant’s estate) agrees to indemnify and hold harmless any Provider who acts in good faith under this Directive from liability arising out of such compliance, except for willful misconduct or gross negligence.

3. Limitation of Liability. Any liability of a Provider acting in good faith under this Directive shall not exceed the limits of applicable professional malpractice insurance.

4. Force Majeure. No party shall be liable for non-performance to the extent performance is impossible due to events beyond reasonable control, including natural disasters or system failures affecting medical facilities.

VIII. DISPUTE RESOLUTION

1. Governing Law. This Directive is governed exclusively by the laws of the State of Nevada without regard to conflicts-of-law principles.

2. Forum Selection. Not applicable.

3. Arbitration. Not applicable.

4. Jury Waiver. Not applicable.

5. Equitable Relief. Nothing herein limits the right of any party to seek injunctive or other equitable relief.

IX. GENERAL PROVISIONS

1. Amendment. Declarant may amend this Directive by executing a subsequent instrument complying with Nevada law.

2. Revocation. Declarant may revoke this Directive at any time by:
   a. A signed, dated writing;
   b. Physical cancellation or destruction of the document;
   c. An oral statement of intent to revoke in the presence of a Provider; or
   d. Execution of a later-dated directive.
   Revocation becomes effective upon communication to the attending Provider.

3. Severability. If any provision is held invalid, the remaining provisions remain in full force to the maximum extent permitted by law.

4. Integration. This Directive constitutes the complete and exclusive statement of Declarant’s advance health-care directive.

5. Counterparts; Electronic Signatures. This Directive may be executed in counterparts and via electronic signature to the extent permitted by law.

X. EXECUTION BLOCK

IN WITNESS WHEREOF, Declarant executes this Directive on the date set forth below.

______ Date: _____
[DECLARANT FULL LEGAL NAME], Declarant

[// GUIDANCE: Declarant must sign in the presence of two qualified adult witnesses OR a notary public. Providers, employees, Agent(s), and persons entitled to inherit cannot serve as witnesses, per NRS 162A.220 & 449.610.]

A. Witness Attestation
We declare under penalty of perjury that: (1) the Declarant signed or acknowledged this Directive in our presence; (2) we are at least 18 years old; (3) we are not the Agent, a health-care provider, or an employee thereof; (4) we are not related to the Declarant by blood, marriage, or adoption; and (5) to the best of our knowledge, we are not entitled to any portion of the Declarant’s estate.

Witness 1: _____ Date: _
Name: [PRINT]
Address: ____

Witness 2: _____ Date: _
Name: [PRINT]
Address: ____

B. Notary Acknowledgment (Alternative to Witnesses)

State of Nevada )
County of ____ ) ss.

On _, before me, __, a Notary Public, personally appeared _____, known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this Directive, and acknowledged that he/she executed the same for the purposes therein contained.

Notary Public for the State of Nevada
My commission expires: ____

ATTACHMENT A
REVOCATION OF DIRECTIVE

This written Revocation is executed pursuant to Section IX.2 of the Directive.

I, [NAME], hereby REVOKE in its entirety the Nevada Advance Health-Care Directive dated [DATE].

______ Date: _____
[DECLARANT SIGNATURE]

Witness 1: _____ Date: _
Witness 2: _____ Date: _

[// GUIDANCE: Deliver copies of this revocation to the primary Agent, alternate Agent(s), and all known Providers to ensure timely effectiveness.]