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Click ‘Get Form’ to open the advance directive form in the editor.
Begin by filling out Part I, where you state your intent to create a mental health advance directive. Clearly write your name and affirm your capacity to make decisions.
In Part II, specify when this directive becomes effective. Choose either 'Immediately upon signing' or 'If I become incapacitated'.
Complete Part III by selecting the duration of the directive. You can choose for it to remain valid indefinitely or set an expiration date.
In Part IV, indicate when you may revoke this directive. Choose between revoking only when you have capacity or even if incapacitated.
Proceed to Part V, where you provide preferences and instructions about treatment, medications, and hospitalization options. Be specific about your choices.
Fill out Parts VI through IX as needed, appointing an agent and providing any additional instructions regarding personal affairs and notifications.
Finally, sign the document in Part IX and ensure witnesses sign as required to validate your advance directive.
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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.Read more
Advance Care Planning - California Department of Justice
Many resources are available on how to prepare advance health care directives, including sample forms and FAQs provided by health and hospice care providers.Read more
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