Advance Health Care Directive Questionnaire

What’s Included:

✔ Principal Information – Name, contact details, and date of birth.
✔ Health Care Agent Selection – Space to designate a primary agent and alternates, along with their contact information.
✔ Medical Treatment Preferences – Sections to specify life-sustaining treatments, pain management, and organ donation wishes.
✔ End-of-Life & Comfort Care Instructions – Clearly express preferences for palliative care and quality-of-life decisions.
✔ Special Instructions & Religious Preferences – Additional space to outline any specific health care directives or beliefs.
✔ Customizable & Fillable PDF Format – Clients can easily complete the form digitally or print and fill it out by hand.

Why You Need This Questionnaire:

✅ Streamline Estate Planning – Organizes key health care decisions in one place for attorneys and clients.
✅ Ensure Client Wishes Are Honored – Helps individuals document their preferences to guide loved ones and medical providers.
✅ Reduce Stress & Confusion – Provides a clear and structured way to communicate medical treatment preferences.
✅ Easy to Use & Share – A fillable, downloadable PDF that can be completed and stored securely.

📥 Instant Download – Fillable & Ready to Use
Plan ahead for peace of mind—Download your Advance Health Care Directive Questionnaire today!