Advanced Health Care Directive

Everyone should fill out an Advanced Healthcare Directive.  It is a simple form you can fill out that tells your doctor and loved ones exactly what to do at the end of your life, or if you cannot speak for yourself. 

CenCal Health has a free, simple form that you can use. Just print it out, complete the form, and sign it. Then give copies to your doctors, family, and/or friends. This will make sure that your values and choices are met.

Click below to download the simple, easy-to-use Advanced Healthcare Directive Form.

If you cannot print the form, we can send you a free copy. Just call the Health Education Request Line at (800) 421-2560 ext. 3126.