Advance Care Planning Tools & Resources List

A collection of useful advance care planning related tools and resources for healthcare providers and consumers.

Related Training And Information

Coalition for Compassionate Care of California Professional Training

Widely used curricula supporting Advance Care Planning, Physician Orders for Life Sustaining Treatment (POLST), and culturally congruent care (Building Bridges).

CSU Shiley Haynes Institute for Palliative Care 

Prepare for Your Care

A web site designed to empower people to make decisions, talk with providers, and get medical care that is right for them. Prepare for Your Care walks people through the basic steps in advance care planning and provides prompts and videos to help them get started.

Consumer Reports (Advance Care Planning)

Free, downloadable patient ACP booklet available in English and Spanish.

Respecting Choices

Evidence-informed training program and resources to promote person-centered care and ACP.

Caring Connections

Caring Connections is a program of the National Hospice and Palliative Care Organization (NHPCO) that provides free resources and information to help people make decisions about end-of-life care before a crisis. There are links to Advance Directives for all 50 states.

National Institute on Aging

General material, definitions, and explanations for Advance Care Planning. Printable Wallet Card. Links to other resources.

American College of Physicians

Document on Advance Care Planning Implementation for Practices.

American Bar Association

Tool kit and handouts for approaching and completing Advance Directives. Includes sections on “How to Choose an Agent” and “Starting the Conversation,” plus links to state specific Advance Directives.


Conversation Tools & Guides

Chinese American Coalition for Compassionate Care (Heart to Heart®)

Heart to Heart® cards are a bilingual (Chinese/English) communication activity designed to make it easier to understand what people might prefer when their lives are threatened by injury or disease.

Go Wish Cards

Go Wish cards from the Coda Alliance offer a non-threatening way to explore people’s preferences for care when seriously ill.

The Conversation Project

Stories for sharing, tools, and tips for initiating Advance Care Planning. The primary focus of the Conversation Project and their material is to help people overcome barriers to planning and to start talking to family and loved ones.

Advance Care Planning Conversation Guide

A guide from the Coalition for Compassionate Care of California.

Ariadne Labs (Serious Illness Care)

Ariadne Labs consolidates evidence-supported videos, tools and resources to support decision making for the seriously ill.

Learn how to take the first steps to begin the conversation. Workbook and toolkit available. Information for community engagement and empowerment.

Common Practice (Hello/Gift of Grace)

The website has information on the evidence-based conversation game Hello (formerly Gift of Grace) to assist people in discussing what matters most to them.

American Society of Clinical Oncology (ASCO Answers: Advanced Cancer Care Planning)

A free downloadable decision-making guide for patients and families facing serious illness with information and resources about care options, communication tips and coping at end of life.

A Physician’s Guide to Talking About End-of-Life Care

Article: J Gen Intern Med. 2000 Mar; 15(3): 195–200.

A Culturally Responsive Approach to Advance Care Planning: A Reflection

Article: Managed Health Care Connect


Advance Care Planning Forms

Prepare for Your Care: Easy to Read Advance Directive

Giving Someone a Power of Attorney for Your Health Care: A Guide with an Easy-to-Use Legal Form for All Adults

Prepared by The Commission on Law and Aging, American Bar Association.

Basic California Advance Care Planning Form

Advance Directive For Dementia

Available online, this resource offers a simple way to document 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.

California Physician Orders for Life-Sustaining Treatment (POLST) Form

Available in English and multiple translations.

National POLST (Physician Orders for Life-Sustaining Treatment) Collaborative

Information and patient resources on each state’s POLST efforts.



California Health Care Foundation: Advance Care Planning, Death & Dying

Five brief videos depict people as they reflect on their experiences with advance care planning, death and dying.

Dr. Angelo Volandes: ACP Decisions

ACP Decisions Tools and videos by Dr. Angelo Volandes.


Billing For Advance Care Planning

Billing for Advance Care Planning Conversations

Web-based training for health providers presented by CSU Shiley Haynes Institute for Palliative Care and the Coalition for Compassionate Care of California.

Guide to Medicare Advance Care Planning Codes

Medicare Learning Network

2016 Medicare Physician Fee Schedule, Final Rule

Medicare Physician Fee Schedule policy governing ACP services, Pages 70955–70959

Billing for Advance Care Planning – FAQs

Coalition for Compassionate Care of California



Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life

2014 Institute of Medicine consensus report on end-of-life care in the United States

Dying in California: A Status Report on End-of-Life Care in California

California Health Care Foundation

Conversation Starters: Research Insights from Clinicians and Patients on Conversations About End-of-Life Care and Wishes

John A. Hartford Foundation, Cambia Health Foundation and California Health Care Foundation.

Conversation Stopper: What’s Preventing Physicians from Talking with Patients about End-of-Life and Advance Care Planning?

John A. Hartford Foundation, Cambia Health Foundation and California Health Care Foundation.

Final Chapter: Californians’ Attitudes and Experiences with Death and Dying (2012)

Lake Research Partners and the Coalition for Compassionate Care of California

Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices

Bernacki RE, Block SD, for the American College of Physicians High Value Care Task Force. JAMA Intern Med.2014;174(12):1994-2003. doi:10.1001/jamainternmed.2014.5271