Advance Health Care Directive (AHCD)

It is often difficult for individuals to think about the care and treatment they want in the event they are incapable of making their own health care decisions. However, completing an Advance Health Care Directive (AHCD) is important for all individuals over 18 years of age as they may unexpectedly be in a position where they cannot speak for themselves, such as an accident or severe illness.

An AHCD allows individuals to appoint an agent who has power of attorney to make care and treatment decisions on their behalf, and give instructions about their health care wishes.

The AHCD form is available below, and at PAMF's Community Health Resource Centers at the Dublin, Fremont, Mountain View and Palo Alto Centers. To make an appointment for a free consultation please call:

• Dublin Center: 925-875-6150
• Fremont Center: 510-623-2231
• Mountain View Center: 650-934-7380
• Palo Alto Center: 650-614-3200

Available Documents:

• Advanced Health Care Directive Form—English form (.pdf)
• Directiva Por Anticipado De La Atencion De La Salud—Spanish form (.pdf)
• Easy Reader AHCD—English form (.pdf)
• Easy Reader AHCD—Spanish form (.pdf)
• AHCD FAQs (.pdf)
• ACHD Terminology (.pdf)

Once you have completed the form and had your signature notarized or witnessed, take a photocopy to your primary care physician, so that it can be placed in your medical record. Give a copy to your agent(s). Keep the original for your personal records.

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