Advance Health Care Directive (English and Spanish)

The Advance Health Care Directive is a legally binding form that lets you exercise your right to give instructions about your own health care and/or to name someone else to make health care decisions for you in the event you are unable to speak for yourself. If you use this form, you may complete or modify all or any part of it. You are free to use a different form. In any case, agents designated and signatures required must be done in the manner prescribed on this form and mandated by the California ... Read More

End of Life Values-Choices Checklist

English The End of Life Values-Choices Checklist is a form that lets you think about end of life choices and values, and commit them to writing. If you prefer, you can download the End of Life Values-Choices Checklist in Microsoft Word (.doc) format. Spanish The End of Life Values-Choices Checklist is a form that lets you think about end of life choices and values, and commit them to writing. If you prefer, you can download the End of Life Values-Choices Checklist in Microsoft Word (.doc) ... Read More

Go Wish Cards, Elizabeth S. Menkin, MD

Go Wish cards order information, Frequently Asked Questions and examples of clinical uses of these Values Sorting Cards helpful when considering end of life choices are provided at this site. The Go Wish cards were created by Elizabeth Menkin, MD and the CODA Alliance to simplify advance care planning choices and assist with setting goals of care. Now available in Spanish. Visit Go Wish Cards, Elizabeth S. Menkin, MD ... Read More

Making a Plan – Thinking Ahead

Making A Plan - Thinking Ahead helps you think about what care you want and do not want if you cannot speak for yourself. It empowers you to have your wishes known and honored if you are unable to guide your own care because of serious illness including a mental health crisis, frailty or the ending of life. It includes a Workbook, a Forms booklet, and the companion piece titled: Mental Health Supportive Care Plan. Together these materials comprise the "Making a Plan Toolkit." In addition to helping ... Read More

Medic Alert Bracelet

MedicAlert® is the leading personal health record repository for medical information with its famous Medic Alert bracelet and medical id alert necklaces recognized worldwide. Medic Alert bracelets and necklaces are used to inform emergency responders about medications, do not resuscitate orders and other information important if you are unable to speak for yourself.

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Mental Health Supportive Care Plan

No matter what our health problems may be, it is important that we are all recognized and respected as being the best source of information about ourselves and what is important to us. If you are unable to make decisions or communicate for yourself when facing mental health challenges, the Mental Health Supportive Care Plan (MHSCP) could help guide people you trust, your designated Health Care Agent and health professionals when providing needed care and support. It can help you direct them to make ... Read More

Physician Orders for Life-Sustaining Treatment (POLST)

Physician Orders for Life-Sustaining Treatment (POLST) is a document to help ensure that a patient’s wishes are known and honored toward the end of life. It uses a standardized medical order used to indicate which types of life-sustaining treatment a seriously ill patient wants or doesn’t want if his or her condition worsens. POLST assists health care providers and patients or their surrogate to develop a transferable care plan of desired interventions when dealing with serious, life-limiting ... Read More

Prehospital Do Not Resuscitate Form & Information

This form was developed by the CA Emergency Medical Services Authority, in concert with the CA Medical Association and emergency medical services (EMS) providers, for purposes of instructing EMS personnel to forego resuscitation attempts in the event of a patient's cardiopulmonary arrest. This form orders that no medical procedure be done to restart breathing or heart functioning if the heart stops beating or a person stops breathing. This form does not prevent a person from obtaining other emergency ... Read More

PREPARE for your care

This site operated by the PREPARE Team was founded by Rebecca Sudore, MD, FAAHPM, Professor of Medicine, Geriatrics Division, University of California, San Francisco, PREPARE Director. In addition to simple language Advance Health Care Directives in many languages and user friendly video guidance, the site also includes a new section called Be PREPARED: Take Control with a “Medical Planning Guide” and a “Guide for A Hospital Go Bag During COVID-19.” The site also now includes COVID Resources ... Read More

Thinking Ahead 2: My Way, My Choice, My Plan

This title is no longer in use. It was the working title for Making A Plan – Thinking Ahead and used while we worked to adapt the original Thinking Ahead publication for Behavioral Health purposes to include advance care planning for serious illness. The original Thinking Ahead – My Way, My Choice, My Life at the End was created in 2007 by the Coalition for Compassionate Care of California and partners including the California Department of Developmental Services and focus groups from three CA ... Read More