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Other Names: California Living Will California Advance Healthcare Directive California Medical Directive California Advance Medical Directive California Advance Health Care Directive
California Advance Directive document preview

What is a California Advance Directive?

A California Advance Directive is a legal document that sets forth your wishes related to medical care, such as your acceptance or refusal of a medical treatment, and/or appointment of a chosen decision maker. 
 
The individual making an Advance Directive is called the "principal," and the individual or organization obtaining authority to carry out the principal's wishes is called the "agent." Designed for California residents, this Advance Directive can be used in San Diego County, Orange County, Los Angeles County, and in all other regions in the state. Each California Advance Directive from Rocket Lawyer can be completely customized for your specific circumstances. With this official legal document on hand, your medical providers will have a record of your decisions, and your agent(s) will be able to offer proof that they have the authority to make choices for you when you are not able.

When to use a California Advance Directive:

  • You're making sure your loved ones aren't put in the position of making important end-of-life healthcare decisions for you.
  • You're about to draft a complete estate plan, and want to make sure life-sustaining treatments are covered.

Sample California Advance Directive

The terms in your document will update based on the information you provide

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LIVING WILL

and

HEALTH CARE POWER OF ATTORNEY

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

(LIVING WILL)

(HEALTH CARE PROXY)

(LIVING WILL AND HEALTH CARE PROXY)

DECLARATION

and

HEALTH CARE PROXY

LIVING WILL

and

MEDICAL DURABLE POWER OF ATTORNEY

DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE-SUPPORT SYSTEMS

HEALTH CARE INSTRUCTIONS

DOCUMENT CONCERNING THE APPOINTMENT OF A HEALTH CARE REPRESENTATIVE FOR HEALTH CARE DECISIONS

OF

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

and

DESIGNATION OF HEALTH CARE SURROGATE

DECLARATION

and

STATUTORY FORM

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

A LIVING WILL

A Directive to Withhold or to Provide Treatment

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

LIVING WILL DECLARATION

and

COMBINED DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND HEALTH CARE REPRESENTATIVE APPOINTMENT

DECLARATION

and

DESIGNATION OF ADVOCATE FOR HEALTH CARE DECISIONS

HEALTH CARE POWER OF ATTORNEY

DECLARATION OF A DESIRE FOR A NATURAL DEATH

and

HEALTH CARE POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

ADVANCE HEALTH-CARE DIRECTIVE

INSTRUCTIONS FOR HEALTH CARE

and

HEALTH CARE POWER OF ATTORNEY

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION

HEALTH CARE PROXY OF

ADVANCE DIRECTIVE OF

LIVING WILL DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

ADVANCE CARE PLAN

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

ADVANCE DIRECTIVE

and

MEDICAL POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION TO PHYSICIANS

(WISCONSIN LIVING WILL)

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

AND

MEDICAL POWER OF ATTORNEY

 

I. LIVING WILLI. ADVANCE DIRECTIVEI. DECLARATIONI. DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE SUPPORT SYSTEMSI. A LIVING WILL - A DIRECTIVE TO WITHHOLD OR TO PROVIDE TREATMENTI. LIVING WILL DECLARATIONI. HEALTH CARE INSTRUCTIONSI. DECLARATION OF A DESIRE FOR A NATURAL DEATHI. HEALTH CARE DIRECTIVEI. DECLARATION TO PHYSICIANS (WISCONSIN LIVING WILL)Declaration made this ______ day of ____________________, _____. I, , willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare:This is an important legal document known as an advance directive. It is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known because of illness or injury. These wishes are usually based on personal values. In particular, you may want to consider what burdens or hardships of treatment you would be willing to accept for a particular amount of benefit obtained if you were seriously ill. You are encouraged to discuss your values and wishes with your family or chosen spokesperson, as well as your physician. Your physician, other health care providers, or medical institution may provide you with various resources to assist you in completing your advance directive. Brief definitions are listed below and may aid you in your discussions and advance planning. Initial the treatment choices that best reflect your personal preferences. Provide a copy of your directive to your physician, usual hospital, and family or spokesperson. Consider a periodic review of this document. By periodic review, you can best assure that the directive reflects your preferences. I, , being of sound mind, willfully and voluntarily make this Declaration for my care to be followed if I become unable to express my desires directly as a consequence of physical or mental incapacity or disability, regardless of whether this is caused by illness, accident, or other injury. This document is intended to direct all persons who are involved with my care including my relatives, physicians or personal representatives which I have appointed, or which hereafter may be appointed by the courts.
even if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be continued to prolong my life as long as possible within the limits of generally accepted health care standards.

__________ (initial) I have a terminal condition

__________ (initial) or I have an irreversible condition

__________ (initial) or I am in a persistent vegetative state

AND if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

 

TO RECEIVE artificially administered nutrition and hydration (food and fluids).NOT TO RECEIVE artificially administered nutrition and hydration (food and fluids) procedures, except as deemed necessary to provide me with comfort care.However, if at any point it is determined that it is not possible that the fetus could develop to the point of live birth with continued application of life-prolonging procedures, it is my preference that this document be given effect at that point. If life-prolonging procedures will be physically harmful or unreasonably painful to me in a manner that cannot be alleviated by medication, I request that my desire for personal physical comfort be given consideration in determining whether this document shall be effective if I am pregnant. I have discussed these decisions with my physician and have also completed a Physician Orders for Scope of Treatment (POST) from that contains directions that may be more specific than, but are compatible with, this Directive. I hereby approve of those orders and incorporate them herein as if fully set forth. I have not completed a Physician Orders for Scope of Treatment (POST) form. If a POST form is later signed by my physician, then this living will shall be deemed modified to be compatible with the terms of the POST form.

 

I designate , who may be reached at , as my Primary Physician.

 

 

 

 

 

 

 

 

including but NOT including . unless I initial the following line:

 

(YOU MUST DATE AND SIGN THIS LIVING WILL AND DESIGNATION

(YOU MUST DATE AND SIGN THIS DESIGNATION

IN THE PRESENCE OF TWO WITNESSES)

I affirm that this Living Will and Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

I affirm that this Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

 

I designate , who may be reached at , as my Primary Physician.

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this living will by . Further, at least one of us is not a spouse or blood relative of .

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this Living Will and Designation by . I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

 

Date: ______________________________

 

Date: ______________________________

The foregoing instrument was acknowledged before me this _____ day of ____________________, ______ by , who is personally known to me or who has produced ________________________________ as identification.

Before me, a Notary Public (or justice of the peace) in and for said county, personally appeared the above named , ________________________________, and ________________________________, who acknowledged that they did sign the foregoing instrument, and that the same is their free act and deed. In testimony whereof, I have hereunto subscribed my name at ________________________________, this _____ day of ____________________, ______.

This instrument was acknowledged before me on this _____ day of ____________________, ______ by .

On this _____ day of ____________________, ______, before me personally appeared , to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed same as his/her free act and deed.

On this _____ day of ____________________, ______, before me, ________________________________, personally appeared , known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same as for the purposes therein contained.

In witness whereof, I hereunto set my hand and official seal.

 

_________________________________

My commission expires _____________

You should sign this document in the presence of a notary public. You should sign this document in the presence of two witnesses who then sign the document in your presence and in each other's presence. You should sign this document in the presence of a notary public and two witnesses who then sign the document in your presence and in each other's presence.

(your Agent)

You should discuss the document and your wishes with any person you want to designate as an Agent before doing so to assure they agree to act on your behalf.

 

California Advance Directive FAQs

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  • How do I write an Advance Health Care Directive in California?

    It's very easy to outline your medical wishes using a free California Advance Directive template from Rocket Lawyer:

    1. Make the document - Provide a few basic details, and we will do the rest
    2. Send and share it - Review the document with your healthcare agent or get legal help
    3. Sign it - Required or not, witnesses and notarization are recommended

    This method is often going to be much less expensive and less time-consuming than hiring and working with a conventional attorney. If necessary, you can start this Advance Directive on behalf of your spouse or another relative, and then have them sign once you've drafted it. Please note that for an Advance Directive to be accepted as legally valid, the principal must be an adult who is mentally competent when they sign. If the principal has already been declared incompetent, a conservatorship could be necessary. When facing such a scenario, it is a good idea for you to connect with a lawyer .

  • Why should I write an Advance Directive?

    Everyone over 18 years old ought to have an Advance Healthcare Directive (both a Living Will and a Healthcare Power of Attorney). While it is tough to think about, a time might come when you can no longer make your own healthcare decisions. Common situations in which you might find it useful to make or update your Advance Directive include:

    • You will be hospitalized for surgery
    • You are getting older or have declining health
    • You've been given a terminal diagnosis
    • You are preparing to move into a care facility

    Whether this California Advance Directive is being prepared as part of a long-term plan or made in response to a change in your health, notarization and witnesses are highly encouraged as a best practice for protecting this document and/or your agent if their privileges are disputed by a third party. Please note that in California, this document is not valid during pregnancy.

  • Do I need a lawyer for my Advance Directive in California?

    Making an Advance Directive is normally straightforward, but you may have legal questions. Having an attorney look over your document may take longer than you'd expect on your own. An easier approach could be through attorney services at Rocket Lawyer. Rocket Lawyer members can request advice from an Rocket Lawyer network attorney with relevant experience or ask additional questions. As always, you can be confident that Rocket Lawyer is here by your side.

  • How much might it typically cost for a lawyer to help me make an Advance Directive in California?

    The cost of hiring and working with a conventional lawyer to make an Advance Directive might range anywhere between two hundred and one thousand dollars. Rocket Lawyer isn't your average Advance Directive template website. With us, anyone under a Rocket Lawyer Premium membership has access to up to 40% in savings when hiring an attorney from our network.

  • Are there any additional actions that I should take after I have made my California Advance Directive?

    After creating this customized Advance Directive with the help of Rocket Lawyer, you will be able to view it wherever and whenever you choose. With a Premium membership, you can edit it, save it as a Word or PDF document, print it out, and/or sign it. Alongside each California Advance Directive, there's a list of tips on what you should do next. You should send a final copy of the signed document to your agent(s), care providers, and other impacted parties.

  • Does an Advance Directive need to be notarized or witnessed in California?

    The specifications governing Advance Directives will vary by state; however, in California, your document must be acknowledged by a notary public or signed by two witnesses. Witnesses to an Advance Directive should not be any employer or operator of the healthcare or community/residential care facility providing your care. Only one of the witnesses may be someone who is an heir, a beneficiary, or otherwise legally related to you (such as a spouse, adopted child, or family member). As a basic rule, witnesses will need to be at least 18 years old, and no witness should also be named as your agent.

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