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 have a say in how you want to be cared for if you can’t speak for yourself.

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.

Easy-to-Read Advance Directive

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

  • English
  • 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.

With Words, Pictures, and Symbols

Thinking Ahead is an advance directive workbook and DVD 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 all persons in need of articulating treatment preferences at the end of life. Available in English, Spanish, Chinese, and Korean. Learn more about all of the Thinking Ahead materials.

American Bar Association Advance Directive

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

Five Wishes

Available through Aging with Dignity, this easy-to-use, plain-language workbook helps you express your wishes for end-of-life care in a living will that meets the legal requirements in most states.

Advance Health Care Directive Kit (CMA)

Available through the California Medical Association in English and Spanish. $6.00 per kit.

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 Jehovah’s Witnesses

Available for download from Cedars-Sinai.

Out-of-State Advance Directive Forms

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