Advance Directive - FAQ
- One or more of the sections is completed
- The form is signed and dated by you, the patient. The form can be signed by another adult at the request of the patient and in the patient’s presence.
- The form is properly witnessed
- Your signature in Part 5 must be witnessed, by either two witnesses or notarized by a notary public. The witnesses can only include one blood relative and your power of attorney cannot serve as a witness or any City of Hope employee.
- At City of Hope we have free notary services, you can arrange for an appointment by going to the Biller Patient and Family Resource center and request an appointment or by calling 626-218-CARE (2273). Your assigned social worker will be notified to review the document before it is notarized.
- Provide a copy to your agent(s) and keep one for yourself.
- Provide a copy to Medical Records at City of Hope. It will be electronically attached to your medical record.
- Provide a copy to all other medical facilities where you receive care.
- Signing a written statement to that effect.
- Destroying the original and all copies.
- Telling at least two people that you are terminating them.
- Completing a new advance health care directive.
Yes. That decision is entirely up to you. But, it’s an important decision that should be discussed with your loved ones and your health care team. Some people feel comfortable making a living will, while many others do not. Talk with your doctor regarding your medical condition in addition to family and friends to determine what is best for you.
To discuss questions in regards to completing your advance health care directive, contact the Biller Patient and Family Resource Center at 626-218-CARE (2273). Your assigned social worker will then be notified to assist you.
You can ask your doctor, nurse or clinical social worker for the form or you can get a copy at the Sheri & Les Biller Patient and Family Resource Center at City of Hope. You can also access and print this.
City of Hope Advance Directive forms can be found online in English, Spanish and Chinese. You also have the option of completing your Advance Directive on Prepare for Your Care where you can view testimonials and a step by step guide to help you complete an Advance Directive.