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11109 Parkview Plaza Drive
Fort Wayne, IN 46845
11050 Parkview Circle
11108 Parkview Circle
Parkview Regional Medical Center Campus
11130 Parkview Circle Drive, Entrance 7
11115 Parkview Plaza Drive
2200 Randallia Drive
Fort Wayne, IN 46805
1720 Beacon Street
1316 E. 7th Street
Auburn, IN 46706
2001 Stults Road
Huntington, IN 46750
207 North Townline Road
LaGrange, IN 46761
401 Sawyer Road
Kendallville, IN 46755
10 John Kissinger Drive
Wabash, IN 46992
1260 East State Road 205
Columbia City, IN 46725
1355 Mariners Drive
Warsaw, IN 46582
10622 Parkview Plaza Drive
Below you will find links to forms you may need during your time with Parkview Health.
Recently, Indiana passed a law that changed how Indiana residents complete advance directive documents.
The new law does not mandate the use of a specific form. Indiana residents now have greater flexibility in determining the forms they want to use, including “Five Wishes” and “Prepare for Your Care.” The Indiana Patient Preferences Coalition, a statewide group which promotes high-quality advance care planning, created a standardized Indiana advance directive document that can be found here.
This advance directive (AD) is a legal document you can use to:
In completing this advance directive, you should carefully consider who to name as your HCR, including considering who your backup representative could be.
You should also reflect on what matters most to you so that your AD aligns with your values and beliefs. For assistance with this form and education about sharing health care wishes with the people who matter most, please email email@example.com or use MyChart to schedule a free advance care planning conversation.
Advance directive documents that you have already completed can be emailed to firstname.lastname@example.org or uploaded through MyChart to be entered into your electronic medical record.
Taking the above steps is very important. We cannot honor your wishes unless we know what they are, have a conversation about them and have copies of the documents.
Please note that prior to this change there were three forms that were recognized by Indiana law and maintained by the Indiana State Department of Health:
Those forms are no longer available. However, if you completed one of these forms prior to December 31, 2022, it remains valid, and you do not have to complete a new document unless you choose to do so.
When your child is injured or becomes ill and you can’t be there, we’ll provide the necessary medical attention. This form enables healthcare professionals to treat your child for minor emergencies when, and only when, you cannot be notified.
By filling out the form, you'll be able to provide not only your permission for medical treatment, but also important health information needed for the care of your child. You may want to keep one copy for yourself and give another copy to the person who will be responsible for your child when you cannot be present. Be sure to specify that person’s name on the form.