Advance Directive Forms

A California Advance Health Care Directive, also known as an advance directive, is a form that allows you to name someone you trust to make medical decisions for you in an emergency and/or detail what medical treatments you want and don't want if you can’t speak for yourself.

California Basic Advance Directive

Available in English, Spanish, or Chinese, this form enables you to give instructions about your own healthcare treatment, your end-of-life wishes, and to appoint a healthcare power of attorney or "healthcare agent."

Out-of-State Advance Directive Forms

Available through the National Hospice and Palliative Care Organization, this site offers state-specific advance directive forms for download.

Easy-to-Read Advance Directive
 
"PREPARE for Your Care"

Written in plain language, this form is intended to be read and understood easily, even by those who have difficulty with complex legal language or have limited reading skills. The form is available in the following languages:

  • English
  • Arabic with English translation
  • Armenian with English translation
  • Chinese with English translation
  • Farsi with English translation
  • Khmer with English translation
  • Korean with English translation
  • Russian with English translation
  • Spanish with English translation
  • Tagalog with English translation
  • Vietnamese with English translation

Click here to download any of these versions.

Advance Directive With Words, Pictures, and Symbols

Thinking Ahead is an advance directive workbook and video created by CCCC. This advance directive contains words, symbols, and pictures that facilitate discussion and decision making regarding values, goals, and treatment preferences at the end of life. The video serves as an instruction manual, containing vignettes that illustrate in simple, graphic format the purpose and use of the materials.

Although it was originally developed for use by persons with developmental disabilities, Thinking Ahead has proven to be a useful tool for anyone in need of articulating treatment preferences in a crisis or at the end of life; it's available in English, Spanish, Chinese, and Korean. Learn more about all of the Thinking Ahead materials.

Advance Directive for Dementia

Available online, this resource offers a simple way to document the medical care you would want if you had dementia. Developed by Barak Gaster, MD, with help from experts in the fields of geriatrics, neurology, and palliative care.

Advance Directive With Mental Health in Mind

Making a Plan – Thinking Ahead helps individuals with mental health challenges think about what care they would want and do not want if they cannot speak for themselves. It includes a workbook and a forms booklet.

Advance Directive for Catholics

Click here to download.

Advance Directive for Christian Scientists

Click here to download.

Advance Directive for Jehovah’s Witnesses

This advance directive includes specific instructions for refusing blood products. Click here to download.

Advance Directive for Jews

Click here to download.