For Patients

Advance Care Planning


An Advance Directive for health care
AKA "Durable Power of Attorney for health care" - "Living Will" - "Directive to Physicians"


YOU - and everyone over 18 years of age. This documentation of health care proxy and preferences is NOT only for the seriously ill and the elderly. Without an Advance Directive, decision-making complications may arise and your wishes may not be honored.


Because you care for your loved ones! -- and they may need to make health care decisions on your behalf someday.
You will:

  • Name and fully authorize the person you choose to make health care decisions on your behalf when you are unable to do it yourself
  • Provide some guidance about what makes sense to you and what doesn't when it comes to health care decisions

  • Give a gift of love to your circle of loved ones, family and friends - a possibility of having the peace of knowing they are following your wishes if they ever have to make tough decisions.


The best time to do your Advance Directive is when you are with your loved ones, so you can all do it together and participate in the general discussions the process naturally prompts.
But don't put this off!


Do this in the comfort of your own home, for example at a kitchen table, with cups of warm tea for everyone. Focus on the conversation - not the document! You and your loved ones will enjoy the exploration of deep personal preferences, values, hopes, "what makes sense" - and become familiar with differences that exist in your circle about these very personal matters.

When you've finished your Advance Directive, makes copies for everyone you name in it, for your doctor and hospital, and you're done!

Advance Directive Forms

California Advance Health Care Directive Forms

Five Wishes

Five Wishes serves as an Advance Directive and is a legally-valid tool available for your use. Five Wishes helps ensure your wishes, and those of your loved ones, will be respected-even if you cannot speak for yourself.

POLST (Physician Order for Life Sustaining Treatment)

A new law effective 1/1/16 allows Nurse Practitioners and Physician Assistants to sign the California POLST form. The form is now available in ENGLISH and will be available in other languages later in January, 2016. For more information

Click here for more information and to download a copy of the POLST in English, Spanish, Chinese, Vietnamese, Korean, Farsim Armenian, Russian, Tagalog and Hmong.


Click here to download a 2016 California POLST form in English.

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