Complete Your Advance Directive
An advance directive is a legal document that describes the types of medical care you want to receive if you are unable to make medical decisions for yourself.
Your advance directive also tells your medical providers who you have chosen to be your health care agent. Your health care agent is the person you choose to make health care decisions for you if you’re unable to do so for yourself. Your health care agent is a person who will honor your personal health care decisions.
You can change your advance directive anytime.
What Advance Directive form Can You Use?
Cottage Health provides the MyCare advance directive to patients and community members. However, patients can also submit other legal advance directives to Cottage Health, and they will be honored.
Download MyCare:
How Do I Make the Document Legal?
You must sign and date the MyCare document in the presence of either two witnesses or a Notary Public.
Two witnesses must sign a statement on page 13 of the MyCare. By signing, the witness states they (a) know who you are or have been shown proof of your identity, (b) are 18 years old or more, (c) they are not your healthcare provider or working for your provider, (d) are not your healthcare agent, and (e) are not employed in the place where you live. One of the two witnesses must also sign a statement indicating that they are not related to you by blood, marriage, or adoption and will not receive any property or money from you after your death.
A Notary Public can also be used (page 14). Click here for local notary services.
What Types of Decisions Does a Health Care Agent Make for You?
You can indicate on your MyCare Advance Directive the types of decisions your health care agent can make. They could include:
- Choosing your doctors and where you’ll receive care
- Speaking with your medical providers
- Deciding about tests, medicine, and surgery you could have
- Planning for your medical care in California or another state
- Reviewing and releasing your medical record
- Planning for care in a nursing home or residential care facility
- Making arrangements if you die
Who Can Be Your Health Care Agent?
A family member, friend or someone who:
- Is 18 years or older
- Knows you well
- Agrees to accept this responsibility
- Can be trusted to honor your wishes and values
- Can make difficult decisions in stressful situations
- Can be calm and think clearly when talking with your medical providers, family, and friends
- Can be contacted easily by your medical providers
Who Cannot be Your Health Care Agent?
- Your doctor
- Someone who works at the hospital, clinic, or facility where you receive medical care, unless he or she is a family member or registered domestic partner
Can You Have More Than One Health Care Agent?
It’s important you choose one person to be your health care agent. Often, when patients choose more than one health care agent it can be difficult during a medical crisis to reach everyone, for everyone to agree, and for everyone to be calm and think clearly during a difficult situation.
You can choose a second and third health care agent for medical providers to contact in case your first health care agent is unavailable. Be sure to discuss your health care decisions with your second and third health care agents too.
