(a) Forms for requests regarding resuscitative measures printed after January 1, 1995, shall contain the following:

“By signing this form, the legally recognized health care decisionmaker acknowledges that this request regarding resuscitative measures is consistent with the known desires of, and with the best interest of, the individual who is the subject of the form.”

(b) A printed form substantially similar to that described in subparagraph (A) of paragraph (2) of subdivision (a) of Section 4780 is valid and enforceable if all of the following conditions are met:

1. (1) The form is signed by the individual, or the individual’s legally recognized health care decisionmaker, and a physician.
2. (2) The form directs health care providers regarding resuscitative measures.
3. (3) The form contains all other information required by this section.