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    California Advance Health Care Directive Form


    Make sure your family and your doctor know what your wishes are regarding medical treatment and life support with this free Advance Health Care Directive Form for California.

    • An Advance Health Care Directive speaks for you if you are unable to communicate due to illness or injury.
    • In Part 1 of the form you can, but are not required to, name another person to act as your agent, to make health care decisions on your behalf if you become unable to do so, or even if you retain capacity.
    • You can give instructions about your health care in Part 2, for your agent (if you appoint one) and for your health care provider to follow.
    • The form includes information and instructions to help you complete it.
    • This is Form 3-1 issued by the California Hospital Association.
    • Available in PDF format.
    Download Type: Adobe PDF
    Last Updated: 02-June-2023
    SKU: 4249
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