WALLET CARD
You may want to use one of the attached cards. Cut it out, fold it in half and keep it in your wallet. Use the first card if you have a power of attorney, use the second card if you only have instructions.
CARD FOR USE WITH HEALTH CARE POWER OF ATTORNEY
WITH OR WITHOUT INSTRUCTIONS.
NOTICE TO MENTAL
HEALTH PROVIDERS
I have an advance directive for mental health care as allowed by Maine law 18-A M.R.S.A. §5-801 et seq. A copy is located at:
_______________________________________________
_______________________________________________
Please obtain a copy of my directive and follow any instructions I have included.
I appointed ____________________________________ as my agent to make decisions for me. My agent can be reached at the following numbers.
Days____________________ Eves._________________
Please contact my agent immediately if I am in need of mental health care and unable to make decisions myself.
Name:____________________________________
Date of Birth:______________________________
CARD FOR USE WITH HEALTH CARE ADVANCE DIRECTIVE WITHOUT A POWER OF ATTORNEY
NOTICE TO MENTAL
HEALTH PROVIDERS
I have an advance directive for mental health care as allowed by Maine law 18-A M.R.S.A. §5-801 et seq. A copy is located at:
____________________________________________
____________________________________________
Please obtain a copy of my directive and follow the instructions I have included for care.
I have included instructions in it for mental health care that I should receive that I have consented to receive should I be unable to make decisions for myself.
Name:___________________________________
Date of Birth:____________________________ | 
