Forms

Useful legal forms and resources

The forms available here allow you to take an active role in planning for your current and ongoing health care and for management of your wealth and property during your life and after your passing. Providing information on your own wishes will relieve your loved ones of the burden of making difficult decisions on your behalf in situations where you are unable to express your preferences.

Our Peace of Mind Box Checklist will help you gather and organize all important materials and documents to support your ongoing and final wishes. Having everything in one place will also help your loved ones in handling your affairs if necessary.

In order to qualify for nursing home Medicaid assistance, part or all of your income may be directed to a Qualified Income Trust, also known as a Miller Trust. This form will provide information for establishing your trust: Miller Trust — with instructions (PDF)Miller Trust – with instructions

Make your wishes known and relieve your loved ones of difficult decisions in a stressful and emotionally charged situation by using the Funeral Planning Declaration and

Obituary Fact Sheet available here.

If you are unable to give instructions regarding your medical care in extreme situations, the Living Will Declaration provides guidance for family members and medical personnel.

Our Checklist of Documents Needed for a Medicaid Case helps you gather all the supporting documents to enable us to file your appeal for Medicaid assistance to pay for extended nursing home care.

The Indiana Physician Orders for Scope of Treatment – POST provides medical professionals with your goals of care and desired medical interventions based on your current health situation. You may revise or revoke those directions when you have more information or if your health situation changes.

Peace of Mind Checklist (PDF)

Miller Trust — with instructions (PDF)

Funeral Planning Declaration (PDF)

Obituary Fact Sheet (PDF)

Living Will Declaration (PDF)

Checklist of Documents Needed for a Medicaid Case (PDF)

Indiana Physician Orders for Scope of Treatment — POST (PDF)