Building Your Plan
Get started with your plan today. Click below to find tools that help you learn more about medical treatment and decision making. Go to our interactive tool to create your living will and learn more about planning.
For more information on Advance Care Planning, please contact us at (727) 467-7423.
Click to view/download forms:
- Healthcare Surrogate and Living Will form – English
- Healthcare Surrogate and Living Will form – Spanish
- Healthcare Surrogate form – English
- Living Will form – English
- Guide to Living Will form – Spanish
- Guide to Creating your Living Will in Spanish
- Dementia Living Will Extension in English
- Dementia Living Will Extension in Spanish
Click to view/download fact sheets:
Fact Sheets in Spanish
Lo Que Debe Saber Sobre Los Antibioticos
Lo Que Debe Saber Sobre La RCP
Lo Que Debe Saber Sobre La Dialisis
Lo Que Debe Saber Sobre La Alimentaciaon por Sondra
Lo Que Debe Saber Sobere Los Respiradores
Advance Care Planning (ACP) – A thoughtful process of planning for future medical care should you become unable to make your own decisions due to a life-limiting illness or injury. It involves education, reflection, communication and documentation. It is a valuable tool for families as they face difficult decisions about caring for you in your final phase of life. Studies show that families that engage in the ACP process have less stress, confusion and guilt about their decisions.
Advance Directive – A broad term that includes documents that allow you to give instructions in the event you can no longer make decisions due to illness or incapacity. (e.g. living will, designation of healthcare surrogate, durable power of attorney, etc.)
Do Not Resuscitate (DNR) Order – A medical order that instructs medical personnel to not use cardiopulmonary resuscitation (CPR) or ventilation if the person is not breathing or has no pulse after suffering cardiac or respiratory arrest.
Guardian – A person appointed by the court to be responsible for the care and management of another person whom the court has determined is no longer capable of making independent decisions.
Healthcare Surrogate (HCS) – An adult chosen to make healthcare decisions for an individual who is too sick or injured to make decisions for him or herself. The HCS makes decisions and takes actions based on what a patient would make or do if he or she were able.
Healthcare Proxy – If a healthcare surrogate has not been designated or if it is unknown whether one exists, then a healthcare facility may appoint a default decision maker called a healthcare proxy.
Incapacity – A court determination concerning the ability of a person to make self-care or financial decisions. People are presumed to have capacity unless there is evidence to the contrary.
Last Will and Testament (Will) – A legal document that communicates how a person wishes personal assets and property to be passed on after death.
Living Will – A written or oral statement about how you want medical decisions made should you not be able to make them yourself.
Long-term Care Ombudsman – A person who investigates and resolves complaints on behalf of residents of nursing homes and other long-term care facilities.
Patient Self-Determination Act – A federal law requiring hospitals to uphold patients’ rights to make personal healthcare decisions. According to the act, a patient has the right to refuse treatment and resuscitative measures.