Share Your Preferences

As a patient, what do you want to know about your care?

Everything. No sugarcoating. Tell me every downside and the chances things won’t go well.

Just share what’s absolutely necessary. No need to hear what might go wrong.

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I'm not sure

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What are your concerns about care?

I’m worried that I won’t get enough care.

I’m worried that I’ll get overly aggressive care.

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I'm not sure

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If I had a terminal illness, I would prefer to…

Not know how quickly it is progressing.

Know my doctor’s best estimation for how long I have to live.

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I'm not sure

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What makes you happy that would be important at the end of life

(Check all that apply)

Being in my home

Being somewhere else special to me:

Being with certain people:

Doing something while I still can:

Being present at a special event:

Something else:

I'm not sure Next

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What else should your doctors and loved ones know about how you want to be treated if someone else is making your health care decisions?

My answer:

I'm not sure Next

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Who do you trust to make your health care choices if you can't?

I trust:

I'm not sure Next

← Back

Great start thinking through
your preferences.

Now, name your health care agent and share
your preferences for care with that person.

Print answers

Name your agent

share your preferences

Your loved ones need your plan.
We’ll help you make it.

Answer 6 questions to make a plan for your care or, if you have one, share it with loved ones.

Share Your Preferences

Question: 1 of 6

As a patient, what do you want to know about your care?

What are your concerns about care?

If I had a terminal illness, I would prefer to…

What makes you happy that would be important at the end of life

What else should your doctors and loved ones know about how you want to be treated if someone else is making your health care decisions?

Who do you trust to make your health care choices if you can't?

Great start thinking through
your preferences.

Now, name your health care agent and share
your preferences for care with that person.

Take me right to:

share your preferences

Your loved ones need your plan. We’ll help you make it.

Answer 6 questions to make a plan for your care or, if you have one, share it with loved ones.

Share Your Preferences

Question: 1 of 6

As a patient, what do you want to know about your care?

What are your concerns about care?

If I had a terminal illness, I would prefer to…

What makes you happy that would be important at the end of life

What else should your doctors and loved ones know about how you want to be treated if someone else is making your health care decisions?

Who do you trust to make your health care choices if you can't?

Great start thinking through your preferences.

Now, name your health care agent and share your preferences for care with that person.

Take me right to:

Your loved ones need your plan.
We’ll help you make it.

Great start thinking through
your preferences.

Now, name your health care agent and share
your preferences for care with that person.