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This booklet is designed to assist individuals in expressing their personal preferences and choices for end-of-life care. It encourages reflective thinking on their health care decisions to ensure

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How to fill out my advance care plan

01

Start by reviewing any existing documents or instructions regarding your healthcare preferences.

02

Gather personal information including your full name, address, and date of birth.

03

Specify your healthcare preferences by outlining your wishes about life-sustaining treatments (e.g., CPR, ventilation).

04

Designate a healthcare proxy or agent who will make decisions on your behalf if you are unable to.

05

Include any specific instructions about pain management and comfort care.

06

Consider discussing your plan with family members or your healthcare provider for clarity.

07

Complete the form by signing and dating it, and ensure it complies with your local laws.

08

Distribute copies of the completed advance care plan to your healthcare proxy, family, and healthcare provider.

Who needs my advance care plan?

01

Your healthcare provider needs your advance care plan to ensure that your treatment aligns with your wishes.

02

Family members may require this document to understand your preferences during medical emergencies.

03

Your appointed healthcare proxy or agent must have access to the plan to act on your behalf.

04

Anyone involved in your care, including close friends and caregivers, should know your advance care plan.

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What is my advance care plan?

An advance care plan is a document that outlines your preferences for medical treatment in case you become unable to communicate your wishes due to illness or injury.

Who is required to file my advance care plan?

Typically, you or your designated healthcare proxy are responsible for filing your advance care plan with healthcare providers and ensuring it is included in your medical records.

How to fill out my advance care plan?

To fill out your advance care plan, review your treatment preferences, consult with healthcare professionals if needed, and complete the necessary forms, ensuring all signature requirements are met.

What is the purpose of my advance care plan?

The purpose of your advance care plan is to ensure that your healthcare preferences are known and respected, guiding your medical treatment if you cannot communicate your choices.

What information must be reported on my advance care plan?

Your advance care plan should include personal information, specific treatment preferences, designation of a healthcare proxy, and any legal directives such as living wills or do-not-resuscitate orders.

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