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Review of Advance Care Planning (ACP) websites and form
July 2013
Background
Advance Care Planning is the process of discussion and shared planning for future health
care. It gives individuals the
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How to fill out review of advance care

How to fill out a review of advance care:
01
Start by gathering all relevant medical and legal documents related to your advance care planning, such as living wills, healthcare powers of attorney, and any other paperwork you might have.
02
Review these documents and make sure they accurately reflect your current wishes regarding medical treatment and end-of-life care.
03
Consider consulting with a healthcare professional, such as your primary care doctor or a specialist in palliative care or hospice, to ensure that your wishes are well-informed and aligned with your current medical condition.
04
Use the review form provided by your healthcare provider, hospital, or online resources. This form will typically include sections for personal information, healthcare proxy designation, treatment preferences, and specific instructions for end-of-life care.
05
Fill in your personal information accurately, including your full name, contact details, and date of birth.
06
Designate a healthcare proxy, someone you trust to make medical decisions on your behalf if you become unable to do so. Provide their full name, contact information, and relationship to you.
07
Express your treatment preferences, such as whether you want life-sustaining measures, resuscitation, or specific interventions such as feeding tubes or ventilators. Make sure to consider different medical scenarios and how you would like to be treated in each case.
08
Include any specific instructions or preferences you have for end-of-life care, such as wishes regarding pain management, religious or cultural traditions, or personal beliefs.
09
Review the completed review form carefully, making sure all information is accurate and reflects your intended wishes.
10
Sign and date the form and consider having it witnessed or notarized, depending on legal requirements in your jurisdiction.
11
Keep a copy of the completed review form for yourself, and provide copies to your healthcare proxy, primary care doctor, and any other healthcare providers involved in your care.
Who needs a review of advance care?
01
Adults of all ages can benefit from completing a review of advance care. It is especially important for those who have been diagnosed with a serious illness, are entering advanced age, or have a higher risk of medical emergencies.
02
Individuals with chronic illnesses or conditions that may lead to incapacitation or the need for critical care should also have a review of advance care in place.
03
A review of advance care is particularly important for individuals who want to ensure their wishes are respected and followed in the event they are unable to communicate or make decisions for themselves due to sudden illness or injury.
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What is review of advance care?
The review of advance care is a process where individuals evaluate and update their advance care directives to ensure they reflect their current healthcare wishes.
Who is required to file review of advance care?
Individuals who have previously created advance care directives are required to file a review of advance care to ensure their wishes are up to date.
How to fill out review of advance care?
To fill out a review of advance care, individuals should review their existing advance care directives, make any necessary updates, and submit the revised document to their healthcare provider and/or legal representative.
What is the purpose of review of advance care?
The purpose of review of advance care is to ensure that individuals' healthcare wishes are accurately documented and reflect their current preferences in the event they are unable to make decisions for themselves.
What information must be reported on review of advance care?
The review of advance care should include information on the individual's preferred medical treatments, end-of-life care preferences, and designated healthcare proxy or decision-maker.
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