What choices do I make on each document?

Each document has its own page where you choose what it says. The choices are different for the two kinds of document. They refuse different things.

Refusal of anatomical gift

Open Refusal of anatomical gift to set your choices.

Organ, eye and tissue donation. Ticked already, and required. It is what the document is: it refuses donation of your organs, eyes and tissue, and bars anyone else from authorizing it on your behalf.
The brain apnea test. Optional. The apnea test is how brain death is determined, and a determination of brain death is what allows donation to proceed. This choice is separate from the same one on the advance directive, so you may refuse it on one document and not the other.
The state you sign it in. Required. The blank cites that state's act by name, so it cannot be prepared without it.

Advance directive (treatment refusal directive)

Open Advance directive to set your choices. What you refuse here is up to you; you can refuse one, two, or all three categories. A directive that refuses nothing cannot be printed.

Vaccines

Tick Vaccines and immunizing agents to refuse them, including any given under a standing order or a facility protocol without discussing it with you first.

If you tick it, you must also answer: does your vaccine refusal include prophylaxis after an exposure? That is treatment given after a suspected exposure rather than as routine immunization: tetanus after a wound, rabies after an animal bite, hepatitis B after a needlestick. Rabies is very nearly always fatal once symptoms start, and prophylaxis is the whole of the treatment, so there is no default. The options are:

You choose	What it means
Refuse prophylaxis too	The refusal covers routine vaccines and post-exposure shots, and the document says you understand this can be fatal
Accept prophylaxis after an exposure	The refusal covers routine immunization only. If a clinician determines you have been exposed, prophylaxis may be given
Something else, in my own words	For refusing some prophylaxis and accepting other prophylaxis. Your sentence goes on the signed paper as you write it, and the document cannot print with this box empty

Blood

Tick Donor blood to refuse transfusion of whole blood, red cells, white cells, platelets, and plasma, from any donor, under all circumstances.

Two questions follow, and neither has a default:

Fractions. Albumin, immunoglobulins, clotting factor concentrates, fibrin sealants, and other products made from donated blood.

You choose	What it means
Refuse fractions too	None of these may be given
Accept fractions	These products may be given even though donor blood is refused

Your own blood, recovered and returned. No donor is involved. Cell salvage collects the blood you lose during an operation and gives it back; hemodilution takes some at the start and returns it at the end.

You choose	What it means
Accept all of it	Cell salvage, hemodilution, and blood you stored in advance for yourself. The document asks that they be used where they would help
Accept it only if it never leaves a circuit connected to me	Cell salvage where the equipment stays in a continuous circuit with your body. Not blood that has been stored
Refuse it	Nothing returned to you after it has left your body, including blood you donated in advance for your own use

The signed paper also states that refusing blood products is not a refusal of care, and asks for every other available treatment: measures to control bleeding, medicines that support your own blood production, and fluids.

Brain apnea testing

Tick this to refuse an apnea test in an evaluation for brain death, on this document. This is separate from the same choice on the refusal of anatomical gift; each document asks independently.

What each refusal looks like on your page

When someone scans your code, the record page shows each refusal under its own heading. Acceptances (fractions you accepted, prophylaxis you accepted) show in the same weight as the refusal above them, so a clinician reading at speed sees both what you refuse and what you allow.