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The MCM Advance Directive has been approved as a "common document" by the major West Michigan hospitals. 

On this page you will find English and Spanish versions of documents with which you can complete an Advance Care Plan. Making Choices Michigan recommends taking advantage of a no-cost facilitated conversation, which involves setting up an appointment with a certified Respecting Choices® Facilitator. Your MCM Facilitator will use these documents as part of your Advance Care Planning experience. The Facilitator is skilled at helping you clarify your personal values, beliefs and preferences for end of life care. The meeting moves at your own pace, and there is no pressure to influence your treatment preferences. There is no cost for this service. 

To set up an appointment, or for more information, please complete the CONTACT form.

The first file below is the OVERVIEW. It is important to download and read that information. It is included separately from the Advance Directive and Treatment Preferences forms for more efficient file management. The second file below is ADVANCE DIRECTIVE & PATIENT ADVOCATE DESIGNATION. This is the primary document that needs to be completed. If you wish to provide specific Treatment Preferences in addition to your Advance Directive, download the TREATMENT PREFERENCES file. All of these files are "fillable" Adobe Acrobat PDF files, which you can download to your computer by right-clicking and saving. If you have the Acrobat Reader plug-in installed on your computer and browser, you can complete the forms right on your computer, but you will need to print them out for valid legal signatures. Make sure you save a copy of your completed PDF on your computer or a removable USB device.

We have also included a template to prepare wallet cards you can carry. These are the same size as a credit card, and if you click on the image below, it will open a fillable Adobe Acrobat PDF form you can then print out and trim.

To download the PDF files, right-click on any of the images below and save to your desktop. 

THE UPDATED SPANISH VERSIONS ARE CURRENTLY BEING TRANSLATED AND WILL BE UPLOADED TO THIS SITE AS SOON AS AVAILABLE.


MCM-AD-OVERVIEWMCM-AD-2015MCM-AD-TREATMENTMCM-AD-WALLETGLHC-RELEASE-FORM






 

 

 

 

 

 

 

 


Click below for English/Spanish versions
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MCM-AD-REFERENCE-overview-SMCM-AD-REFERENCE-AD-SMCM-AD-REFERENCE-Treatment-SMCM-AD-REFERENCE-WALLET-S

 

Steering Committee

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