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Click ‘Get Form’ to open the UCLA Advance Directive in the editor.
In Part 1, designate your primary agent by filling in their name, address, and contact information. You may also add an alternate agent if needed.
Specify when your agent's authority becomes effective by choosing between having it activated immediately or upon your physician's determination of incapacity.
In Part 2, express your health care wishes regarding end-of-life decisions. You can choose to prolong life or not and provide instructions for pain relief.
If you wish to donate organs, complete Part 3 by indicating which organs you wish to donate and for what purposes.
Finally, sign the form in Part 5 and ensure it is witnessed appropriately as per the requirements outlined.
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What is the California Advanced Health Care Directive?
This form lets you choose the kind of health care you want. This way, those who care for you will not have to guess what you want if you are not able to tell them yourself. The form must be signed before it can be used. This is a legal form that lets you have a voice in your health care.
What is the purpose of the Advance Health Care Directive?
An advance health care directive lets your physician, family, and friends know your health care preferences, including the types of special treatment you want or dont want at the end of life, your desire for diagnostic testing, surgical procedures, cardiopulmonary resuscitation and organ donation.
What is the UCLA Health Advance Health Care Directive?
An Advance Health Care Directive lets you name someone of your choice to make treatment decisions for you. That person can make most medical decisions - not just those about life-sustaining treatment when you are unable to speak for yourself.
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Advanced Healthcare Directive - Harbor-UCLA Medical
The California legislature has enacted law allowing you to give instructions about your health care by completing an advanced health care directive form.
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