Free · Private · Printable

Your healthcare wishes,
in your own words.

An advance directive ensures the people you love — and the clinicians caring for you — know exactly what you want. Takes about 10 minutes.

🔒 Stored on your device only 📝 5 short sections 🖨 Ready to print & sign
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New to advance care planning?
Clinicians recommend clarifying your values before filling out a directive. It makes every answer here easier and more meaningful.
Start with Values →
For informational purposes only. This tool helps you organize your healthcare wishes. It is not a substitute for legal advice. Consult your healthcare provider and an attorney familiar with your state's laws to ensure your document meets all requirements for valid execution in your jurisdiction.
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Info
Agent
Care
Values
Review
Step 1 of 5
Personal Information

This information identifies you on the printed document. It stays on your device and is never sent anywhere.

A Your Name
B Home Address
Saved
Step 2 of 5
Healthcare Agent

Your healthcare agent (also called a healthcare proxy or durable power of attorney for healthcare) makes decisions for you if you are unable to speak for yourself. Choose someone you trust completely.

Primary Agent Required
Alternate Agent Recommended

Serves if your primary agent is unable or unwilling to act.

C Instructions for Your Agent

Optional. For example: "Please consult with my oncologist before any major decisions."

Saved
Step 3 of 5
Treatment Preferences

These are your preferences for specific medical interventions. There are no right or wrong answers — only what is right for you.

D Life-Sustaining Treatment
CPR (Cardiopulmonary Resuscitation)
Attempts to restart your heart if it stops. Includes chest compressions and possibly electric shocks.
Mechanical Ventilation
A machine breathes for you when you cannot breathe on your own. May be temporary (after surgery) or long-term.
Artificial Nutrition & Hydration
Feeding tubes or IV fluids when you cannot eat or drink. Can sustain life for extended periods.
Comfort Care & Pain Management
Medications and care focused on relieving pain and discomfort, even if it does not extend your life.
Organ & Tissue Donation
Whether you wish to donate organs or tissue after death to help others.
E Additional Treatment Notes

Optional. For example: "If I am in a permanent vegetative state, I do not wish for life support."

Saved
Step 4 of 5
Values & Goals

This is the heart of your advance directive. Your words here will guide your care team and your loved ones more than any checkbox ever could.

F What Matters Most to Me

Think about: quality of life vs. length of life, independence, being at home, being conscious, being free of pain, connecting with loved ones.

G What I Want My Family to Know

This is your chance to say what you need them to hear — so they can honor your wishes without guilt.

H Spiritual & Cultural Considerations

Optional. For example: "I am Catholic and find comfort in last rites. Please ensure a priest is called."

I Where I Want to Be
Saved
Step 5 of 5
Review & Generate

Review your advance directive below. When you're ready, download or print it — then sign it with witnesses and a notary as required by your state.

Your document is ready. Print it, sign it with two witnesses (who are not your healthcare agent or beneficiaries), and have it notarized if required in your state. Keep a copy with your important papers and give one to your healthcare agent and your doctor.

Your browser's print dialog will open. Choose "Save as PDF" to save a copy.

💊 Also organize your medications — every ER visit asks for this list.

Build My Medication List & Emergency Card →

💬 Now share your wishes with family — guided prompts make the conversation easier.

Start the Family Conversation →

📋 Bundle everything together — your directive, medications, and emergency info in one printable care plan for your provider.

View My Complete Care Plan →
📬 Get guidance on advance care planning & caregiving