Advance Directive Forms

We want to ensure that you and your loved ones have the most comfortable experience during your time at the hospital. In order to ensure you get care according to your preferences, consider completing an Advance Directive prior to your hospitalization.  This form allows you to name an individual whom you trust to make healthcare decisions for you in the event you become mentally or physically unable to communicate your wishes. We have provided valuable links and PDF documents that you can download regarding Advance Directive.

Click on the titles below to view the forms. You will need Adobe Reader to view the PDF Files. If you do not have Adobe Reader, you can download it for free by clicking the link below.

Advance Healthcare Directive (English)

You have the right to give instructions about your own health care. You also have the right to name someone else to make health care decisions for you. The Advance Health Care Directive form lets you do one or both of these things. It also lets you write down your wishes about donation of organs and the selection of your primary physician. If you use the form, you may complete or change any part of it or all of it. You are also free to use a different form.

Advance Healthcare Directive (Spanish)

Usted tiene derecho a dar instrucciones sobre la atención de su salud. También tiene derecho a designar a otra persona para que tome decisiones sobre la atención de su salud en su nombre. Este formulario también le permite escribir sus deseos sobre la donación de órganos y la designación de su médico de atención primaria. Si utiliza este formulario, puede completarlo o cambiar cualquier parte del mismo. También puede utilizar un formulario diferente, si lo desea.