Advanced Health Care Directive Checklist


o Talk with family members, friends, spiritual advisors, physicians, other health-care providers and other trusted persons about what would be important to you if you become terminally or irreversibly ill or injured and you can no longer communicate your health-care decisions or other wishes.


o Ask someone you trust and whom you can count on to be your health-care agent and discuss your wishes with this person. Select an alternate health-care agent in case your agent is unable to serve.


o Complete either one of the enclosed simplified forms, change or cross out provisions or make an entirely different document.  Add pages if you like.


o Have two qualified witnesses or a notary witness your signature.


o Inform family members, spouse, parents, children, siblings, friends, physicians and othe rhealth-care providers that you have executed an advance health-care directive and that you expect them to honor your instructions. Keep them informed about your current wishes.


o Give copies of the document to your health-care agent, health-care providers, family, close friends, clergy or any other individuals who might be involved in caring for you.


o Place the executed document in your medical files.


o When you renew your driverŐs license or state I.D, you may designate that you have an advance directive by putting  (AHCD) on it.


o Make plans to review the document on a regular basis—make a new document, if necessary, and keep people informed of any changes.


o Do it today!