Guidelines for completing the advance care planning worksheets

Advance care planning worksheets

You may choose to work through the worksheets below on your own or you might want to discuss them with people close to you.

If you feel that some of the questions are not relevant to you, leave them for the moment and move on to other questions.

You may want to write your answers to the questions or use them to provide some structure to a conversation about your values and wishes.

As with other worksheets on this website, you can either print out a blank copy or save a Word version to your computer so that you can complete, make changes at any time and print out the completed worksheet.

When you complete each worksheet in this section, you should sign and date it, and have at least one person witness your signature. This person should also provide their contact details. Although there is no specific legal requirement for this, it is a sensible thing to do in case there is any doubt in the future about the validity of the document.

The questions presented in these worksheets represent one example of an advance care planning format. There are a number of other formats available from other programs and these are listed in the resources section of the website.

Worksheet 1.4: general statement about values, wishes and preferences

Complete the worksheet by downloading a blank copy and filling it in.

Worksheet 1.5: advance care directions about specific treatments

Complete the worksheet by downloading a blank copy and filling it in.


Step 5: Discuss your wishes and plans