For Patients

Advance Healthcare Directive

California and federal law give every competent adult, 18 years of age or older, the right to make their own healthcare decisions, including the right to decide what medical care or treatment to accept, reject or discontinue. If you do not want to receive certain types of treatment, or if you wish to name someone to make healthcare decisions for you, you have the right to make these desires known to your doctor, hospital or other healthcare providers, and have these rights respected. You also have the right to be told about the nature of your illness in terms that you can understand, the general nature of the proposed treatments, the risks of failing to undergo these treatments and any alternative treatments or procedures that may be available to you.

However, there may be times when you cannot make your wishes known to your doctor or other healthcare providers. For example, if you were critically injured or ill, what would be your specific wishes about the medical care you want to receive?

Advance Healthcare Directives can be used to inform your healthcare team about medical care and treatment options as well as your right to select another person to make decisions for you if you are physically or mentally unable to make them.

Your nurse will ask you if you have a completed Advance Healthcare Directive. If you have questions about completing an Advanced Healthcare Directive, or would like to complete an Interim Directive, please seek help from your nurse, case manager, social worker or spiritual care personnel.

Click here for an Advance Healthcare Directive.

Advance Directive Tool Kit

This tool kit inclues 16 tools to assist families in having the conversation, selecting a healthcare decision maker and completing and Advance Directive. Click here to view the Advance Directive Tool Kit.

Advance Directive Forms

California Advance Health Care Directive Forms

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 visit www.capolst.org

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.

POLST Forms

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