Advance Directive Forms

What is Advance Care Planning?

Advance care planning is thinking about what health care you might want in the future. This type of planning includes talking about, writing down, and sharing what is important to you. This helps others make health care decisions for you if you cannot make your own decisions.

What is an Advance Directive?

An advance directive is a voluntary, legal way to write down your advance care planning decisions. You should share your advance directive with people who matter to you—like your health care agent and loved ones—and your health care providers, clinic, and hospital. An advance directive should be updated regularly. All adults 18 and older can complete an advance directive.

Durable Power of Attorney for Health Care (DPOA-HC)

Overview + DPOA-HC

This full length DPOA-HC advance directive is for naming and preparing a health care agent. This form includes sections to share your goals, values, and preferences to guide your health care agent in making future health care decisions for you. This advance directive includes an overview guide to aid in the completion of the document. This form meets the requirements of Washington state law.

Download the Overview and DPOA-HC Advance Directive below:

• Overview + DPOA-HC – English Fillable This version allows you to fill out the form on your computer before printing.
• Overview + DPOA-HC – English Print This version includes lines for hand-written responses.

These translated forms meet the requirements of Washington state law. This is our first version of translations. It is important to us that the translations are understood and accessible to those that need them. We are actively seeking feedback to improve our translations. Click here to submit your feedback.

• Amharic

  

  Overview + DPOA-HC – Amharic Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Amharic Print This version includes lines for hand-written responses.

   

   

   

   

• Arabic

  Overview + DPOA-HC – Arabic Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Arabic Print This version includes lines for hand-written responses.

   

   

   

   

• Chinese (Simplified)

  

  Overview + DPOA-HC – Chinese (Simplified) Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Chinese (Simplified) Print This version includes lines for hand-written responses.

   

   

   

   

• Chinese (Traditional)

  

  Overview + DPOA-HC – Chinese (Traditional) Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Chinese (Traditional) Print This version includes lines for hand-written responses.

   

   

   

   

• Chuukese

  

  Overview + DPOA-HC – Chuukese – Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Chuukese – Print This version includes lines for hand-written responses.

• Korean

  Overview + DPOA-HC – Korean Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Korean Print This version includes lines for hand-written responses.

   

   

   

   

• Oromo

  Overview + DPOA-HC – Oromo Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Oromo Print This version includes lines for hand-written responses.

   

   

   

   

• Punjabi

  Overview + DPOA-HC – Punjabi Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Punjabi Print This version includes lines for hand-written responses.

   

   

   

   

• Russian

  Overview + DPOA-HC – Russian Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Russian Print This version includes lines for hand-written responses.

   

   

   

   

• Spanish

  

  Overview + DPOA-HC – Spanish Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Spanish Print This version includes lines for hand-written responses.

   

   

   

   

• Somali

  Overview + DPOA-HC – Somali Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Somali Print This version includes lines for hand-written responses.

   

   

• Spanish

  

  Overview + DPOA-HC – Spanish Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Spanish Print This version includes lines for hand-written responses.

   

   

   

   

• Tagalog

  Overview + DPOA-HC – Tagalog Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Tagalog Print This version includes lines for hand-written responses.

   

   

   

• Tigrinya

  Overview + DPOA-HC – Tigrinya Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Tigrinya Print This version includes lines for hand-written responses.

   

   

   

• Ukrainian

  Overview + DPOA-HC – Ukrainian Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Ukrainian Print This version includes lines for hand-written responses.

   

   

   

• Vietnamese

  Overview + DPOA-HC – Vietnamese Fillable This version allows you to fill out the form on your computer before printing.

  Overview + DPOA-HC – Vietnamese Print This version includes lines for hand-written responses.

   

   

   

• Once you complete your advance directive

  Talk about your wishes and give copies of your advance directive to the people who matter to you—like your health care agent and loved ones —and your health care providers, clinic, and hospital. If it applies, consider sharing copies with your nursing home or assisted living facility too. It is important that everyone has a copy.

• If there are changes to your advance directive

  Making changes to your advance directive is common and will happen periodically. When you make changes to your advance directive tell everyone who has a copy, including your health care agent, loved ones, health care providers, clinic, and hospital. You can revoke or void your advance directive at any time. You will need to tell your health care provider that you want to revoke it either by writing them a letter (make sure to sign and date it) or by verbally telling them. It is important to complete a new advance directive. Be sure to give copies of the new advance directive to the people who matter to you – like your health care agent and loved ones – and your health care providers, clinic, and hospital.

• Organ, tissue, and eye donation

  If you want to be a donor, please tell your health care agent, family, and health care providers. You can record your organ, tissue, and eye donation wishes at www.registerme.org.

  More information about organ, tissue, and eye donation is available at www.donatelife.net.

• Funeral planning

  Honoring Choices PNW trusts People’s Memorial Association as a resource and thought leader for funeral choice, education, and advocacy in Washington State.

  The People’s Memorial Association website has information on documenting your funeral choices, like designating a specific person to direct your funeral arrangement and the disposition of your remains.

• Assistance with advance care planning

  Honoring Choices PNW is here to help with your planning. To find a local resource to help you with advance care planning visit: www.honoringchoicespnw.org/locations or contact us at info@honoringchoicespnw.org.