Idaho Statutes Title 39. Health and Safety § 39-4510. Advance care planning document

(a) The person's name, date of birth, telephone number, and mailing address;

(b) The signature of the person for whom the ACPD is created or the authorized agent of such person; and

(c) The date on which the document was signed.

(a) The electronic mail address of the person executing the ACPD;

(b) Nomination of one (1) or more persons to act as a health care agent;

(c) The name, mailing address, electronic mail address, and telephone number of any person nominated as a health care agent, as well as such person's relationship to the person executing the ACPD;

(d) Resuscitation instructions;

(e) Instructions regarding pregnancy;

(g)  1Instructions for the release of information protected by the federal health insurance portability and accountability act;

(h) Instructions for end-of-life care;

(i) A description of treatment objectives;

(j) The names and contact information of witnesses to the execution of the ACPD; and

(k) Notarization.