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The California Advanced Health Care Directive form empowers individuals to outline their preferences for medical treatment in the event they are unable to communicate their wishes due to illness or incapacity. This legally binding document plays a crucial role in health care planning, allowing people to appoint a health care agent who will make decisions on their behalf, and to specify their choices about end-of-life care, organ donation, and other critical health-related decisions. The form acts as a clear guide for family members and health care providers, ensuring that the individual's health care directives are followed according to their explicit instructions. It addresses a wide range of scenarios, from temporary incapacitation to permanent inability to communicate, making it an essential tool for anyone seeking to have control over their future health care. By filling out this form, individuals can ensure that their health care preferences are known, respected, and legally documented, providing peace of mind to themselves and their loved ones.

Sample - California Advanced Health Care Directive Form

ADVANCE HEALTH CARE DIRECTIVE FORM

 

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Probate Code - PROB

DIVISION 4.7. HEALTH CARE DECISIONS [4600 - 4806] ( Division 4.7 added by Stats. 1999, Ch. 658, Sec. 39. ) PART 2. UNIFORM HEALTH CARE DECISIONS ACT [4670 - 4743] ( Part 2 added by Stats. 1999, Ch. 658, Sec. 39. )

CHAPTER 2. Advance Health Care Directive Forms [4700 - 4701] ( Chapter 2 added by Stats. 1999, Ch. 658, Sec. 39. )

4701. The statutory advance health care directive form is as follows:

ADVANCE HEALTH CARE DIRECTIVE

(California Probate Code Section 4701)

Explanation

You have the right to give instructions about your own health care. You also have the right to name someone else to make health care decisions for you. This form lets you do either or both of these things. It also lets you express your wishes regarding donation of organs and the designation of your primary physician. If you use this form, you may complete or modify all or any part of it. You are free to use a different form.

Part 1 of this form is a power of attorney for health care. Part 1 lets you name another individual as agent to make health care decisions for you if you become incapable of making your own decisions or if you want someone else to make those decisions for you now even though you are still capable. You may also name an alternate agent to act for you if your first choice is not willing, able, or reasonably available to make decisions for you. (Your agent may not be an operator or employee of a community care facility or a residential care facility where you are receiving care, or your supervising health care provider or employee of the health care institution where you are receiving care, unless your agent is related to you or is a coworker.)

Unless the form you sign limits the authority of your agent, your agent may make all health care decisions for you. This form has a place for you to limit the authority of your agent. You need not limit the authority of your agent if you wish to rely on your agent for all health care decisions that may have to be made. If you choose not to limit the authority of your agent, your agent will have the right to:

(a)Consent or refuse consent to any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a physical or mental condition.

(b)Select or discharge health care providers and institutions.

(c)Approve or disapprove diagnostic tests, surgical procedures, and programs of medication.

(d)Direct the provision, withholding, or withdrawal of artificial nutrition and hydration and all other forms of health care, including cardiopulmonary resuscitation.

(e)Donate your organs, tissues, and parts, authorize an autopsy, and direct disposition of remains.

Part 2 of this form lets you give specific instructions about any aspect of your health care, whether or not you appoint an agent. Choices are provided for you to express your wishes regarding the provision, withholding, or withdrawal of treatment to keep you alive, as well as the provision of pain relief. Space is also provided for you to add to the choices you have made or for you to write out any additional wishes. If you are satisfied to allow your agent to determine what is best for you in making end-of-life decisions, you need not fill out Part 2 of this form.

Part 3 of this form lets you express an intention to donate your bodily organs, tissues, and parts following your death.

Part 4 of this form lets you designate a physician to have primary responsibility for your health care.

After completing this form, sign and date the form at the end. The form must be signed by two qualified witnesses or acknowledged before a notary public. Give a copy of the signed and completed form to your physician, to any other health care providers you may have, to any health care institution at which you are receiving care, and to any health care agents you have named. You should talk to the person you have named as agent to make sure that he or she understands your wishes and is willing to take the responsibility.

You have the right to revoke this advance health care directive or replace this form at any time.

ADVANCE HEALTH CARE DIRECTIVE FORM

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PART 1

POWER OF ATTORNEY FOR HEALTH CARE

(1.1) DESIGNATION OF AGENT: I designate the following individual as my agent to make health care decisions for me:

(name of individual you choose as agent)

(address)

(city)

(state)

(ZIP Code)

 

 

 

 

 

 

(home phone)

(work phone)

 

 

OPTIONAL: If I revoke my agent's authority or if my agent is not willing, able, or reasonably available to make a health care decision for me, I designate as my first alternate agent:

(name of individual you choose as first alternate agent)

(address)

(city)

(state)

(ZIP Code)

 

 

 

 

 

 

(home phone)

(work phone)

 

 

OPTIONAL: If I revoke the authority of my agent and first alternate agent or if neither is willing, able, or reasonably available to make a health care decision for me, I designate as my second alternate agent:

(name of individual you choose as second alternate agent)

(address)

(city)

(state)

(ZIP Code)

 

 

 

 

 

 

(home phone)

(work phone)

 

 

(1.2) AGENT'S AUTHORITY: My agent is authorized to make all health care decisions for me, including decisions to provide, withhold, or withdraw artificial nutrition and hydration and all other forms of health care to keep me alive, except as I state here:

(Add additional sheets if needed.)

(1.3) WHEN AGENT'S AUTHORITY BECOMES EFFECTIVE: My agent's authority becomes effective when my primary physician determines that I am unable to make my own health care decisions unless I mark the following box.

If I mark this box , my agent's authority to make health care decisions for me takes effect immediately.

ADVANCE HEALTH CARE DIRECTIVE FORM

PAGE 3 of 7

(1.4.) AGENT'S OBLIGATION: My agent shall make health care decisions for me in accordance with this power of attorney for health care, any instructions I give in Part 2 of this form, and my other wishes to the extent known to my agent. To the extent my wishes are unknown, my agent shall make health care decisions for me in accordance with what my agent determines to be in my best interest. In determining my best interest, my agent shall consider my personal values to the extent known to my agent.

(1.5) AGENT'S POSTDEATH AUTHORITY: My agent is authorized to donate my organs, tissues, and parts, authorize an autopsy, and direct disposition of my remains, except as I state here or in Part 3 of this form:

:

(Add additional sheets if needed.)

(1.6) NOMINATION OF CONSERVATOR: If a conservator of my person needs to be appointed for me by a court, I nominate the agent designated in this form. If that agent is not wiling, able, or reasonably available to act as conservator, I nominate the alternate agents whom I have named, in the order designated.

PART 2

INSTRUCTIONS FOR HEALTH CARE

If you fill out this part of the form, you may strike any wording you do not want.

(2.1) END-OF-LIFE DECISIONS: I direct that my health care providers and others involved in my care provide, withhold, or withdraw treatment in accordance with the choice I have marked below:

(a) Choice Not to Prolong Life

I do not want my life to be prolonged if (1) I have an incurable and irreversible condition that will result in my death within a relatively short time, (2) I become unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness, or (3) the likely risks and burdens of treatment would outweigh the expected benefits, OR

(b) Choice to Prolong Life

I want my life to be prolonged as long as possible within the limits of generally accepted health care standards.

(2.2) RELIEF FROM PAIN: Except as I state in the following space, I direct that treatment for alleviation of pain or discomfort be provided at all times, even if it hastens my death:

(Add additional sheets if needed.)

(2.3) OTHER WISHES: (If you do not agree with any of the optional choices above and wish to write your own, or if you wish to add to the instructions you have given above, you may do so here.) I direct that:

(Add additional sheets if needed.)

 

ADVANCE HEALTH CARE DIRECTIVE FORM

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PART 3

 

 

DONATION OF ORGANS, TISSUES, AND PARTS AT DEATH

 

 

(OPTIONAL)

 

(3.1)

Upon my death, I give my organs, tissues, and parts (mark box to indicate yes).

 

By checking the box above, and notwithstanding my choice in Part 2 of this form, I authorize my agent to consent to any temporary medical procedure necessary solely to evaluate and/or maintain my organs, tissues, and/or parts for purposes of donation.

My donation is for the following purposes (strike any of the following you do not want):

(a)Transplant

(b)Therapy

(c)Research

(d)Education

If you want to restrict your donation of an organ, tissue, or part in some way, please state your restriction on the following lines:

If I leave this part blank, it is not a refusal to make a donation. My state-authorized donor registration should be followed, or, if none, my agent may make a donation upon my death. If no agent is named above, I acknowledge that California law permits an authorized individual to make such a decision on my behalf. (To state any limitation, preference, or instruction regarding donation, please use the lines above or in Section 1.5 of this form).

PART 4

PRIMARY PHYSICIAN

(OPTIONAL)

(4.1) I designate the following physician as my primary physician:

(name of physician)

(address)

(city)

(state)

(ZIP Code)

(phone)

OPTIONAL: If the physician I have designated above is not willing, able, or reasonably available to act as my primary physician, I designate the following physician as my primary physician:

(name of physician)

(address)

(city)

(state)

(ZIP Code)

(phone)

ADVANCE HEALTH CARE DIRECTIVE FORM

PART 5

PAGE 5 of 7

(5.1) EFFECT OF COPY: A copy of this form has the same effect as the original.

(5.2) SIGNATURE: Sign and date the form here:

(date)

(sign your name)

(address)

(print your name)

(city) (state)

(5.3) STATEMENT OF WITNESSES: I declare under penalty of perjury under the laws of California (1) that the individual who signed or acknowledged this advance health care directive is personally known to me, or that the individual's identity was proven to me by convincing evidence (2) that the individual signed or acknowledged this advance directive in my presence, (3) that the individual appears to be of sound mind and under no duress, fraud, or undue influence, (4) that I am not a person appointed as agent by this advance directive, and (5) that I am not the individual's health care provider, an employee of the individual's health care provider, the operator of a community care facility, an employee of an operator of a community care facility, the operator of a residential care facility for the elderly, nor an employee of an operator of a residential care facility for the elderly.

First witness

Second witness

(print name)

(address)

(city)(state)

(print name)

(address)

(city)(state)

(signature of witness)

(signature of witness)

(date)

(date)

(5.4) ADDITIONAL STATEMENT OF WITNESSES: At least one of the above witnesses must also sign the following declaration:

I further declare under penalty of perjury under the laws of California that I am not related to the individual executing this advance health care directive by blood, marriage, or adoption, and to the best of my knowledge, I am not entitled to any part of the individual's estate upon his or her death under a will now existing or by operation of law.

(signature of witness)

(signature of witness)

ADVANCE HEALTH CARE DIRECTIVE FORM

PAGE 6 of 7

 

PART 6

SPECIAL WITNESS REQUIREMENT

(6.1) The following statement is required only if you are a patient in a skilled nursing facility--a health care facility that provides the following basic services: skilled nursing care and supportive care to patients whose primary need is for availability of skilled nursing care on an extended basis. The patient advocate or ombudsman must sign the following statement:

STATEMENT OF PATIENT ADVOCATE OR OMBUDSMAN

I declare under penalty of perjury under the laws of California that I am a patient advocate or ombudsman as designated by the State Department of Aging and that I am serving as a witness as required by Section 4675 of the Probate Code.

(date)

(sign your name)

(address)

(print your name)

(city) (state)

 

(Amended by Stats. 2018, Ch. 287, Sec. 1. (AB 3211) Effective January 1, 2019.)

ADVANCE HEALTH CARE DIRECTIVE FORM

PAGE 7 of 7

ACKNOWLEDGMENT

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

State of California,

County of

On

before me,

(insert name and title of officer)

personally appeared

who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person

(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Signature

 

(SEAL)

 

 

 
↓ PDF Form

File Specs

Fact Description
Definition A legal document that allows a person to specify what actions should be taken regarding their health if they are no longer able to make decisions for themselves due to illness or incapacity.
Governing Law California Probate Code, Division 4.7 - Health Care Decisions, Sections 4600-4806.
Components Includes a power of attorney for health care and individual health care instructions.
Effective Date Becomes effective when the person can no longer communicate their health care decisions.
Choice of Agent Allows an individual to appoint an agent to make health care decisions on their behalf.
Decision Making Power The form enables the agent to make decisions about medical treatment, including refusal of treatment.
Instructions for Health Care Individuals can specify their preferences for end-of-life care, including life support and pain relief.
Signature Requirements Must be signed by the principal (or an authorized person on their behalf) and before two witnesses or a notary public.
Revocation The directive can be revoked at any time by the principal, without regard to their mental state.
Legislative Background Enacted to give individuals greater control over their health care decisions towards the end of their lives.

Steps to Filling Out California Advanced Health Care Directive

Completing the California Advanced Health Care Directive form is an important step in ensuring your health care preferences are understood and respected. This document allows you to outline your wishes regarding medical treatment and appoint someone to make decisions on your behalf if you're unable to do so. Below, you'll find a straightforward guide to help you navigate the process of filling out this essential form.

  1. Read the entire form carefully before you begin writing. Understanding each section will help you make informed decisions about your health care.
  2. Start with Part 1, where you'll appoint your health care agent. Write the full name, address, and contact information of the person you trust to make health care decisions for you if you're unable.
  3. In Part 2, outline your instructions for health care. Here, you can specify your preferences regarding treatments like life support, tube feeding, and pain relief. Be as detailed as possible to ensure your wishes are clear.
  4. If you have specific desires about donating your organs or authorizing an autopsy, complete Part 3. This section is optional but important if you have strong feelings about what should happen after your death.
  5. Part 4 is where you can designate a primary physician. Fill in the name, address, and phone number of your chosen doctor. This step is also optional but recommended if you have a preferred medical professional.
  6. Review your entries to ensure all information is accurate and reflects your true wishes. Double-check the spelling of names and accuracy of contact information.
  7. Sign and date the form in the presence of two witnesses or a notary public. Your witnesses must also sign the form, acknowledging that they meet the criteria specified in the instructions.

Once completed, it's crucial to share your Advanced Health Care Directive with your health care agent, family members, and your doctor to ensure your wishes are honored. Keeping a copy where it can easily be found is also a good practice. Remember, you can revise your directive at any time should your wishes or circumstances change.

Discover More on California Advanced Health Care Directive

What is a California Advanced Health Care Directive?

An Advanced Health Care Directive in California is a legal document that allows you to outline your preferences for medical care, including end-of-life care, in the event that you become unable to communicate your wishes. It also enables you to appoint a health care agent, someone you trust to make health care decisions on your behalf if you’re unable to do so.

Who should have an Advanced Health Care Directive?

Anyone over the age of 18 is advised to have an Advanced Health Care Directive in place. It’s important for all adults to express their health care preferences and select a trusted person to act on their behalf if they're unable to make their own medical decisions.

How do I choose a health care agent?

When choosing a health care agent, consider someone who understands your values, is willing to speak on your behalf, and is able to make potentially difficult decisions under stressful circumstances. This person can be a family member, a friend, or anyone you trust to respect your healthcare preferences.

Can I change my Advanced Health Care Directive?

Yes, you can change your Advanced Health Care Directive at any time. To do so, complete a new form and make sure to inform your health care provider, your health care agent, and any other important parties that the new directive replaces the old one.

What should I do with my completed form?

Once your Advanced Health Care Directive is completed, give copies to your health care agent, family, close friends, and your doctors to ensure that your wishes are known. It’s also a good idea to keep a copy in a safe place where it is easily accessible.

Do I need a lawyer to complete an Advanced Health Care Directive?

No, you do not need a lawyer to complete an Advanced Health Care Directive in California. However, it is important to follow the legal requirements for the form to be valid. These requirements include having your signature witnessed or notarized, according to California law.

What happens if I don’t have an Advanced Health Care Directive?

If you become incapacitated without an Advanced Health Care Directive in place, health care decisions will be made for you by a court-appointed conservator, your next of kin, or medical professionals, according to California law. This may result in decisions that are not in line with your preferences or values.

Common mistakes

Filling out the California Advanced Health Care Directive form is an essential step in planning for future healthcare decisions. However, errors can occur in the process, making the document less effective or even invalid. Here are ten common mistakes to avoid:

  1. Not specifying preferences for end-of-life care. Many people leave sections blank regarding preferences for life-sustaining treatments, such as ventilation or feeding tubes, creating ambiguity in critical situations.

  2. Naming an agent who lives far away. Although it's vital to trust the person you appoint to make decisions on your behalf, if they're not readily available in an emergency, this can complicate matters.

  3. Failing to discuss wishes with the appointed agent. Completeness and clarity are only effective if the agent fully understands the signer's healthcare preferences and is willing to advocate for them.

  4. Not updating the form after major life changes. Changes in relationships, health status, or location can affect choices and should prompt a review and possibly an update of the directive.

  5. Leaving out a successor agent. If the primary agent is unable or unwilling to act, having no alternate listed can leave important decisions in the hands of healthcare providers or the court.

  6. Mistaking the form for a Do Not Resuscitate (DNR) order. Some individuals confuse this directive with a DNR order, which is a separate document specifically addressing cardiac or respiratory arrest.

  7. Not signing or dating the form, or doing so incorrectly. The form must be properly executed to be valid; this often includes the necessity of witness signatures or a notarization, depending on state requirements.

  8. Using unclear or ambiguous language. It's important to be as clear as possible to avoid interpretations that could go against the signer's wishes.

  9. Not distributing copies of the completed form to key people, including the healthcare agent, family members, and healthcare providers, which can lead to unnecessary delays and confusion in an emergency.

  10. Assuming the form will be immediately accessible to healthcare providers when needed. It's crucial to ensure that the document is readily available and not locked away in a safety deposit box or another secure location.

Avoiding these mistakes can help ensure that your healthcare wishes are known, understood, and respected. Always seek legal advice if you are unsure how to properly complete or update your California Advanced Health Care Directive form.

Documents used along the form

When it comes to healthcare planning, the California Advanced Health Care Directive (AHCD) form is a critical tool for expressing one's healthcare preferences should they become unable to communicate these wishes directly. However, this document does not exist in isolation. To create a comprehensive healthcare and end-of-life plan, a number of additional forms and documents are often used in conjunction. Each serves a unique role in ensuring one’s healthcare wishes are thoroughly documented and respected. Here's a look at seven pivotal documents often utilized alongside the AHCD form.

  • Living Will: This document complements the AHCD by providing detailed instructions regarding one's end-of-life care preferences. It typically focuses on scenarios not covered by the AHCD, offering a broader scope of directives.
  • Durable Power of Attorney for Healthcare: Although the AHCD includes the appointment of a healthcare agent, some individuals prefer a separate document for this purpose. It designates someone to make health decisions on one’s behalf should they become incapacitated.
  • HIPAA Authorization Form: This form allows healthcare providers to disclose one's health information to designated persons. It is crucial for enabling the individuals chosen in the AHCD or Durable Power of Attorney to access the necessary medical records to make informed decisions.
  • Do Not Resuscitate (DNR) Order: A more specific directive, a DNR order, instructs health professionals not to perform CPR if one's breathing stops or if the heart stops beating. It is usually signed by both the individual and their physician.
  • Physician Orders for Life-Sustaining Treatment (POLST): This medical order addresses end-of-life treatment preferences in more detail than a DNR. It’s designed for individuals with serious health conditions and specifies preferences for treatments like feeding tubes and antibiotics.
  • Organ and Tissue Donation Form: For those interested in organ donation, this form specifies which organs and tissues may be donated after death. It is often attached to the AHCD to ensure the individual's wishes regarding donation are clear.
  • Last Will and Testament: While not a healthcare document per se, the Last Will and Testament is crucial for ensuring one's personal and financial affairs are settled according to their wishes after death. It often complements the AHCD by addressing non-medical end-of-life concerns.

Together, these documents form a comprehensive framework that addresses a wide range of health and end-of-life issues. It's advisable to consult with legal and medical professionals when preparing these documents to ensure they accurately reflect your wishes and comply with California law. By taking a holistic approach to healthcare and end-of-life planning, individuals can provide clear guidance to their loved ones and healthcare providers, alleviating much of the uncertainty and stress that can arise during critical times.

Similar forms

  • Living Will: Just like the California Advanced Health Care Directive (AHCD), a living will specifies a person's preferences regarding medical treatments in situations where they can no longer communicate their wishes, especially concerning life-sustaining procedures. Both documents are designed to guide healthcare providers on how to proceed with treatment based on the person's documented preferences.

  • Durable Power of Attorney for Health Care: This document is similar to the AHCD as it also allows an individual to appoint someone else to make healthcare decisions on their behalf if they are unable to do so themselves. The main difference lies in the scope; while a durable power of attorney for health care focuses solely on decision-making authority, the AHCD also encompasses specific healthcare instructions.

  • Do Not Resuscitate (DNR) Order: A DNR order is a medical order written by a doctor instructing healthcare providers not to perform CPR if a patient's breathing stops or if the patient’s heart stops beating. The AHCD can encompass a DNR order within its directives, allowing individuals to specify their wishes about such emergency procedures in advance.

  • Organ Donation Form: Similar to the AHCD, an organ donation form allows individuals to express their wishes regarding organ and tissue donation after death. The AHCD can include instructions about organ donation, making it a comprehensive document that speaks to various aspects of one’s healthcare and post-mortem wishes.

Dos and Don'ts

In California, the Advanced Health Care Directive form serves as a critical tool, enabling individuals to outline their preferences for medical treatment should they become unable to make decisions for themselves. Here are some do's and don'ts to consider when filling out this form:

Do's:

  1. Ensure all information is accurate and complete. Double-check names, addresses, and phone numbers of those designated to make decisions on your behalf.

  2. Discuss your wishes with the person you appoint as your health care agent. This conversation ensures they understand and are willing to follow your directives.

  3. Be specific about your medical treatment preferences. Clarify conditions under which you would want or not want particular treatments, such as life support.

  4. Sign and date the form in the presence of two witnesses or a notary public, as required by California law. This formalizes your document.

Don'ts:

  1. Do not leave any sections blank if they are applicable to your situation. Incomplete directives may result in confusion or misinterpretation of your wishes.

  2. Avoid using vague language. Precise instructions help ensure your health care provider and agent can honor your wishes.

  3. Do not forget to update your directive as needed. Life changes might prompt adjustments to your document to reflect your current wishes and circumstances.

  4. Resist the temptation to distribute copies without keeping track of who has them. Always know who possesses a copy of your directive to manage updates or revocations efficiently.

Misconceptions

When it comes to planning for future health care decisions, the California Advanced Health Care Directive (AHCD) is a pivotal document. However, misunderstandings about its purpose and use are common. Here are five misconceptions that often arise:

  • An AHCD is only for the elderly. Many people mistakenly believe that an Advanced Health Care Directive is only necessary for older adults. However, unexpected health care situations can happen at any age, and having an AHCD in place ensures your wishes are known and respected, regardless of your age.
  • You need a lawyer to complete an AHCD. It's a common misconception that you must have a lawyer to create an AHCD. While legal advice can be valuable, especially in complex situations, California law allows individuals to complete their directive without a lawyer's help. The form is designed to be user-friendly and includes instructions for completion and execution.
  • An AHCD takes away control from your family. Some people worry that by creating an AHCD, they're relinquishing their family's ability to make decisions on their behalf. In reality, an AHCD clarifies your wishes, aiding your family and doctors in making health care decisions that align with your values and preferences when you're unable to communicate them yourself.
  • Once you've completed an AHCD, it cannot be changed. This misunderstanding might deter individuals from creating an Advanced Health Care Directive early in life. The truth is, you can update or revoke your AHCD at any time as long as you are competent. This flexibility allows your AHCD to evolve with your changing health care preferences and life circumstances.
  • The AHCD covers every aspect of health care planning. While an AHCD is comprehensive, it does not cover every single aspect of health care planning. For example, it typically doesn't address routine financial matters or include detailed instructions for every possible medical scenario. For more comprehensive planning, individuals might consider additional documents like a living will or durable power of attorney for health care.

Understanding these misconceptions is the first step toward effectively utilizing the California Advanced Health Care Directive to ensure your health care wishes are honored.

Key takeaways

Filling out the California Advanced Health Care Directive form is an important step in managing your health care preferences. This document allows you to outline your desires regarding medical treatment in situations where you might not be able to express your wishes yourself. Here are nine key takeaways to consider when dealing with this form:

  • Understand the Parts: The form is divided into two main parts. Part 1 lets you appoint a health care agent. Part 2 is where you specify your health care instructions.
  • Choosing an Agent: When selecting a health care agent, think about someone you trust to make medical decisions for you. This person should understand your values and be willing to advocate on your behalf.
  • Be Specific: The clearer your instructions, the better. Specify what kinds of treatments you do or do not want in certain situations. This can include your thoughts on life support, pain management, and organ donation.
  • Legal Requirements: To make your directive legally binding, you must sign it in the presence of two witnesses or a notary public. Witnesses can't be your health care agent or providers.
  • Discuss Your Wishes: It's vital to discuss your preferences with your chosen agent, family, and even your doctors. This ensures everyone understands your wishes and can act accordingly.
  • Review Regularly: Over time, your feelings about certain treatments may change. Review and update your directive as needed to reflect your current wishes.
  • Distribution: Make sure your health care agent, doctors, and any health care institutions that might treat you have copies of your completed directive.
  • Accessibility: Keep the original document in a place where it can easily be accessed when needed. Inform your health care agent and family members about where you keep it.
  • Understand It's Revocable: You can revoke or change your directive at any time. Make sure to communicate any changes to everyone involved.

By taking these steps, you can ensure that your health care preferences are understood and respected, even when you might not be able to express them yourself.

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