Home > Advanced Care Planning > Advance Directives > Advance Health Care Directive (English and Spanish)

Advance Health Care Directive (English and Spanish)

The Advance Health Care Directive is a legally binding form that lets you exercise your right to give instructions about your own health care and/or to name someone else to make health care decisions for you in the event you are unable to speak for yourself. If you use this form, you may complete or modify all or any part of it. You are free to use a different form. In any case, agents designated and signatures required must be done in the manner prescribed on this form and mandated by the California State Legislature.

It is recommended that you use this form and complete the whole form. Completing this form will revoke any previous health care directives. It is advisable to also complete the Values Checklist we provide and include that as an attachment to your Advance Directive to help clarify your wishes.

Equally important is having meaningful conversations with people who care about you so that they know and understand your wishes concerning end of life care. Guidelines to help Talking Things Over are provided on this site to help you through the process.

Upon completion of your Advance Healthcare Directive, copies should be distributed to family members and those who would care for you in the event of a life-threatening condition. It is also recommended that you keep a current copy of your Advance Directive in the glove box of your vehicle.

PDF format
Download Advance Healthcare Directive in PDF format. (You need the free Acrobat Reader to open and print this file.)

en Espanol
Download Advance Healthcare Directive in Spanish

Comments are closed.