Whilst ADs are normally presented in the form of a written document, they may also take the form of an oral statement in the presence of witnesses, signed cards or notes in the patient’s medical history. However, an advance refusal will only apply to life-sustaining treatment where it is in writing, is signed and witnessed, and contains a statement that it is to apply even where life is at risk.

It is also possible to use a specially preprinted form.

Help can be asked from an advocacy organization such as Dignity in Dying or the Alzheimer’s Society.

Different organizations offer the possibility to guide and register the AD with them.

Documents should be signed and dated by at least one witness of legal age.

It is possible to appoint a health care proxy (“lasting power of attorney”). The appointed person should be over 18 and mentally capable. The appointment should be made in writing, with witnesses and lodged with the Office of the Public Guardian.