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Advance Health Care Directive

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    The documents and processes for making your Life Care Plan vary by state. Please select your region to continue.    

    The documents and processes for making your Life Care Plan vary by state. To begin, please select your region. Your Life Care Plan can be made legally binding in the State of Colorado. Although there are a number of documents and processes legally approved by your state to complete this task, ideally we would like you to complete an AHCD (Advance Health Care Directive). The Colorado MDPOA (Medical Durable Power of Attorney) is also available to legally appoint your health care agent. 

    Please make sure that any legal document you complete is shared with both your health care agent and Kaiser Permanente. 

    If you’d like help with completing your AHCD or MDPOA, call 303-614-1122 (TTY 711).

    Step 1 icon

        

    Complete Colorado’s AHCD or MDPOA form

    You can download and print this form to fill out with a pen or save it to your computer and type into it. To save the form from a browser window, choose File, then Save As, and then rename the file. 

    NOTE: If you don’t rename the file, it WILL NOT save the information you enter.

    Download AHCD form English | Español

    Download MDPOA English

    Follow the instructions in the form to complete it for submission.

    Step 2 icon

       

    Submit your completed and signed AHCD or MDPOA form

    You can submit your completed and signed form in person, online, or by fax. 

    To submit the form in person
    Drop off a printed copy of your form at your local Kaiser Permanente Medical Office. 

    To submit the form online
    Upload a PDF of the form through you account on kp.org: 

    1. Print your completed form.
    2. Sign it and get the witness signatures you need.
    3. Scan the signed form back into your computer.
    4. Sign in to your kp.org account to send a message to your primary care provider, attach the pdf of the advance directive.

    To submit the form by fax
    Fax it to 1-877-847-6309 (please include your medical record number)

    Need help?
    Call 303-614-1122 (TTY 711).

    Step 3 icon

      

    Keep your original, and share copies

    Always store your original AHCD or MDPOA form in a safe place with your other important papers. 

    Make sure you share copies of any legal document related to your AHCD or MDPOA with the people you've designated as your health care agents.