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Alameda County Longer Ombudsman Services 6955 Foothill Boulevard, Suite 300 Oakland, CA 94605 Office (510) 6386878 Fax (510) 5771965 Advanced Health Care Directive Screening Form Staff member: Phone
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How to fill out advanced health care directive

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How to fill out an advanced health care directive:

01
Gather necessary documents: Start by obtaining the appropriate forms for an advanced health care directive. These can usually be found online or obtained from a lawyer or healthcare provider.
02
Fill out personal information: Begin by providing your personal information, such as your full name, date of birth, address, and contact information. This ensures that the document accurately identifies you as the individual for whom the directive is being created.
03
Appoint a healthcare agent: Designate someone you trust as your healthcare agent. This person will be responsible for making medical decisions on your behalf if you are unable to make them yourself. Ensure that the agent is willing to take on this responsibility and discuss your wishes with them beforehand.
04
Specify healthcare instructions: Clearly state your healthcare wishes in the document. This may include instructions regarding life-sustaining treatments, organ donations, and pain management preferences. It is important to be as specific as possible to ensure your wishes are understood accurately.
05
Discuss your wishes with loved ones: It is crucial to inform your loved ones about your advanced health care directive and the decisions you have made. This ensures that they are aware of your wishes and can advocate on your behalf if needed.

Who needs an advanced health care directive:

01
Any adult: Every adult should consider having an advanced health care directive in place. Accidents or unexpected health issues can occur at any age, making it important for individuals to have their medical preferences established in advance.
02
Individuals with chronic illnesses: Those with chronic illnesses or progressive diseases may have specific medical preferences that they want to outline in an advanced health care directive. This document helps ensure that their wishes are known and respected during their treatment.
03
Aging population: As individuals age, their healthcare decisions may become more complex. Having an advanced health care directive allows older adults to express their wishes regarding end-of-life care, alleviating the burden of decision-making from their families.
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An advanced health care directive is a legal document that outlines a person's wishes regarding their medical care in the event they are unable to communicate those wishes themselves.
Any competent adult can file an advanced health care directive, but it is especially recommended for individuals with chronic illness or older adults.
To fill out an advanced health care directive, you will need to clearly state your medical preferences, appoint a health care proxy, and have the document notarized.
The purpose of an advanced health care directive is to ensure that an individual's medical wishes are honored if they become unable to communicate those wishes themselves.
An advanced health care directive should include information about the individual's preferred medical treatments, their health care proxy, and any specific instructions they have for their medical care.
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