California Advance Healthcare Directive Form Printable

California Advance Healthcare Directive Form Printable FORM 3 1 Advance Health Care Directive NOTE This form should include taglines as required by the Afordable Care Act See www calhospital taglines for detailed information Explanation You have the right to give instructions about your own health care You also have the right to name someone else to make health care decisions for you

Part 1 Choose a medical decision maker Page 3 A medical decision maker is a person who can make health care decisions for you if you are not able to make them yourself This person will be your advocate They are also called a health care agent proxy or surrogate Part 2 Make your own health care choices Page 7 Create your advance healthcare directive for California using our free PDF template and instructions Learn about surrogate decision makers in California

California Advance Healthcare Directive Form Printable

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Step 1 A person who has executed an advance health care directive may register information regarding the directive with the Secretary of State This information is made available upon request to the registrant s health care provider public guardian or legal representative A request for information must state the need for the information A California advance health care directive allows an individual to choose an agent to make medical decisions on their behalf and select end of life treatment options An advance directive combines a medical power of attorney and a living will It is recommended to be completed by elderly individuals and those seeking high risk medical procedures

California Advance Health Care Directive This form lets you have a say about how you want to be treated if you get very sick This form has 3 parts It lets you Part 1 Choose a medical decision maker A medical decision maker is a person who can make health care decisions for you if you are too sick to make them yourself Part 1 Choose a health care agent A health care agent is a person who can make medical decisions for you if you are too sick to make them yourself Part 2 Make your own health care choices This form lets you choose the kind of health care you want This way those who care for you will not have to guess

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ADVANCE HEALTH CARE DIRECTIVE INSTRUCTIONS Part 1 of this form lets you name another individual as agent to make health care decisions for you if you become incapable of making your own decisions or if you want someone else to make those decisions for you now even though you are still capable ADVANCE HEALTH CARE DIRECTIVE INSTRUCTIONS Part 1 of this form lets you name another individual as agent to make health care decisions for you if you become incapable of making your own decisions or if you want someone else to make those decisions for you now even though you are still capable

For a revocation change of a written advance health care directive that has been registered previously with the Secretary of State or a revocation of your registration check this box and complete Items 3 and 7 There is no filing fee Revocation change of Prior Directive and New Registration Prepare Your Advance Health Care Directive After learning your options and discussing your wishes prepare an Advance Care Directive Keep a personal copy in a safe and accessible place while letting key people know of your intentions Consider addressing Palliative Care Pain Management and Hospice Care in your advance health care plan

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Advance Health Care Directive Form California Free Download
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https://calhospital.org/wp-content/uploads/2021/04/form_3-1_-_english.pdf
FORM 3 1 Advance Health Care Directive NOTE This form should include taglines as required by the Afordable Care Act See www calhospital taglines for detailed information Explanation You have the right to give instructions about your own health care You also have the right to name someone else to make health care decisions for you

Advance Health Care Directive Form State Of California Printable Pdf Download
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https://prepareforyourcare.org/content/default/common/documents/CA-PREPARE-Advance-Directive-English.pdf
Part 1 Choose a medical decision maker Page 3 A medical decision maker is a person who can make health care decisions for you if you are not able to make them yourself This person will be your advocate They are also called a health care agent proxy or surrogate Part 2 Make your own health care choices Page 7


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California Advance Healthcare Directive Form Printable - California Advance Health Care Directive This form lets you have a say about how you want to be treated if you get very sick This form has 3 parts It lets you Part 1 Choose a medical decision maker A medical decision maker is a person who can make health care decisions for you if you are too sick to make them yourself