VIC Appointment of Medical Treatment Decision Maker – (Long Form) for 3 or more Medical Treatment Decision Makers

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An appointment of a Medical Treatment Decision Maker may be made at the same time as an Advance Care Directive is given or at any other time.

An appointment of a Medical Treatment Decision Maker must:

1️⃣ Be in writing in English;

2️⃣ Include the full name, date of birth and address of the Appointor;

3️⃣ Include any prescribed details in relation to any appointed Medical Treatment Decision Maker;

4️⃣ Be signed by the Appointor or at their direction;

5️⃣ May appoint more than one person as a Medical Treatment Decision Maker;

6️⃣ Must be witnessed in accordance with the Medical Treatment Planning and Decisions Act 2016 (VIC); and

7️⃣ Must be accepted by each appointee in accordance with the Medical Treatment Planning and Decisions Act 2016 (VIC).

The appointed Medical Treatment Decision Maker is the first person listed in the appointment who is reasonably available and willing and able to act at the required time.

Note: Only 2 Medical Treatment Decision Makers can be appointed under the Short Form. More can be appointed under the Long Form.

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