Advance Health Care Directive

Planning medical decisions in case of an accident or illness is something everyone should think about. If there’s an emergency, it’s important to make sure you get the kind of care you want—even if your loved one or doctor has to decide for you.

What is an Advance Health Care Directive?

The Advance Health Care Directive (AHCD) is a legal form that lets you

Choose a health care agent—someone who can make decisions for you if you can’t. This is also called a “durable power of attorney for health care” or “medical durable power of attorney.”
Give instructions about the care you want if you can’t make decisions yourself.
Share your values, hopes, and what matters most to you.

The Advance Health Care Directive also helps you learn about life-sustaining treatments and decide what care you would want. Making these choices now, while you’re healthy, gives you a voice for the future.

It’s a good idea to look at your life care plan from time to time and talk with your loved ones about what’s important to you. You can update your AHCD anytime, especially if your health or life changes. Filling it out while you’re healthy and talking about it with your loved ones can help avoid confusion later and give everyone peace of mind.

How to Complete an Advance Health Care Directive

The forms and steps for making your Life Care Plan are different depending on where you live. To get started, please choose your region.

Your Life Care Plan can be made legally binding in the State of Washington. There are other legally approved ways, but ideally we would like you to complete:

A Medical/Health Care Durable Power of Attorney (MDPOA/DPOA-HC)
An Advance Health Care Directive

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

1. Download and complete Washington’s forms

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

NOTE: If you don’t rename these files, they will not save the information you enter.

MDPOA (Medical/Health Care Durable Power of Attorney)

Download English (fillable form MDPOA)

Download Español (Spanish MDPOA)

Download 中文 (Chinese MDPOA)

Download 한국어 (Korean MDPOA)

Download Русский (Russian MDPOA)

Download Filipino (Tagalog MDPOA)

Download Tiếng Việt (Vietnamese MDPOA)

AHCD (Advance Health Care Directive; Living Will/Advance Directive)

Download English (fillable form AHCD)

Download Español (Spanish AHCD)

Download 中文 (Chinese AHCD)

Download 한국어 (Korean AHCD)

Download Русский (Russian AHCD)

Download Filipino (Tagalog AHCD)

Download Tiếng Việt (Vietnamese AHCD)

Advance Health Care Directive booklet

This booklet walks you through the process of advance care planning and how to fill out the forms. (Both forms are also included in the back of the booklet.)

Download English AHCD booklet

Download Español (Spanish AHCD booklet)

Download 中文 (Chinese AHCD booklet)

Download 한국어 (Korean AHCD booklet)

Download Русский (Russian AHCD booklet)

Download Filipino (Tagalog AHCD booklet)

Download Tiếng Việt (Vietnamese AHCD booklet)

Follow the instructions in the forms to complete for submission.

Please note: Both forms require either two witnesses or a notary in order to be legally valid.

2. Submit your completed and signed forms

You can submit your completed and signed forms to Kaiser Permanente Washington’s Advance Directives Registry in one of three ways:

By email as a PDF

kpadvancedirectives@kp.org

By mail

Kaiser Advance Directives Registry
PO Box 204
Spokane, WA 99210-0204

By fax

509-434-3185

REMEMBER: Do not send your original forms to the Advance Directives Registry. Only send copies.

Questions? Call toll-free 1-877-850-9445.

3. Keep your originals and share copies

Always store your original advance directive forms in a safe place with your other important papers.

Make sure you share copies of your forms and any other legal documents related to your forms with the people you've chosen as your health care agents and your loved ones.

Tell your people

The best way to make your life care plan known is to share your wishes for future health care with the people in your life. Your life care plan can only be acted upon if people know about it. Share it with your health care agent, other loved ones, friends, roommates, and Kaiser Permanente. Share your plan verbally and in writing.

Also, keep any important documents, such as your Advance Health Care Directive, in a place that is easy for you and others to access. Give a copy to your health care agent, your family members, and your doctor.

To update your Advance Health Care Directive

You can change your life care plan at any time, as long as you are capable of understanding and communicating your health care decisions. In fact, it is not unusual to make changes over time. We encourage you to periodically review your values and wishes for your future health care to make sure that what you specified at an earlier point in time continues to reflect what you want.

If you want to make changes to your Advance Health Care Directive (AHCD), you'll need to fill out a new one. Give the new version to your doctor, your agent, and anyone else who has a copy of your old AHCD. Ask your agent and family members to bring you the old versions of your AHCD so you can discard them.

You will also need to let your doctor, agent, and loved ones know of the changes to your life care plan or AHCD. Remember, as long as you are able to speak for yourself, the choices you make while hospitalized will be honored, even if they differ from those expressed in your written AHCD.