Advance Medical Directives should be filled out and notarized.
Then you should make copies of your completed directives to keep in your files, give to loved ones and keep in your vehicle.
Next you should take your medical directives to your doctors, nurse practitioners, specialists, medical facility administrators, employers, schools and public organization that you are a part of who might need to know your wishes in the event that a decision must be made relating to the choices you have put into writing on your directive.
Lastly you need to ask for a receipt showing that you filed your directives with each organization so that it cannot be claimed lost or never submitted. If anyone refuses to accept your directive, mark on it the name of the person and organization who refused to file it for you along with the date and time of refusal. Keep receipts and refusals in your files in case they are needed. If your directive is refused, try to file it with another staff member higher up in the chain of command.
If you have been injured or harmed financially by the actions of an organization or individual who has ignored your filed medical directive, you can take your evidence to an attorney who can advise you of what legal remedies may be available to you since you have evidence to prove your claim.