Category: Advance Care Planning

ACP – page 6

DOCTORS CERTIFICATE By Signing below, I certify that: Name ____________________________________________ Name of practice or facility __________________________________________________ Address of facility or practice __________________________________________________ Phone_____________________________________________ Signature_______________________________ Date __________ Every page has ‘ I choose not to answer the questions on this page ‘

ACP – page 5

By signing below, I confirm: I understand this care directive documents my preferences to guide my healthcare team. In providing appropriate care for me when I am unable to speak for myself I understand treatments that would not benefit me will not be provided even if I have specifically asked for them. I agree that […]

ACP – Page 4

QR code is linked to Appointing someone to make decisions on behalf of you During challenging situations, such as accidents or serious illnesses, you or your loved ones may need to make healthcare decisions. It is advantageous to have contemplated your decision-making preferences and identified individuals you want involved in those choices beforehand. Expressing and […]

ACP – page 3

Everyone desires autonomy in managing their health and making personal decisions. In the event of communication challenges, having a document is beneficial to guide our loved ones and healthcare professionals on how you wish your medical information to be conveyed. Where I live is important to me:    □ Yes    □ No   I would prefer to […]

ACP p2

What is important to them and offers prompts to answer the questions 1st Box: This is to let your loved ones and health professionals know about you and what you value in your life. Some examples 2nd Box: What makes you happy and brings joy to your life? Some examples:  I am making this advance […]

ACP – Page 1

Page 1   –  Talking to your family and loved ones about your wishes for the future healthcare is important, even if you do not write them down. If you do create an Advance care directive (care directive) be sure to share it with your health care team such as GP and anyone else you want […]