Arizona Life Care Planning Full Packet

📄 Complete the Full Arizona Life Care Planning Packet (PDF)

🧭 What’s Inside the Packet?

📝 Step-by-Step Instructions

Section 1: Letter to My Loved Ones

What it is: An optional letter where you can share your thoughts, values, or messages with your family, caregivers, or spiritual advisors.

Ideas to include:

• What quality of life means to you

• Your values or religious beliefs

• What kind of comfort care you want

• Your wishes for your final days or funeral

Helpful Tip: This is not legally binding but can deeply guide your loved ones when making decisions on your behalf.

Section 2: Durable Health Care Power of Attorney

What it does: Legally authorizes someone (your “agent”) to make medical decisions if you can’t.

You’ll need to:

• Enter your full legal name and contact info

• Name a primary health care agent

• Optionally name backup agents

• List any specific instructions or limits on their authority

• Sign in front of either a notary or two witnesses

Helpful Tip: Pick someone who knows your values and can stay calm in a crisis.

Section 3: Living Will

What it does: States your preferences about life-sustaining treatments if you’re terminally ill, in a coma, or unable to express your wishes.

You’ll choose whether you want:

• CPR (resuscitation)

• Artificial feeding or fluids

• Pain relief (even if it may shorten life)

• Other treatments like dialysis, breathing machines, etc.

Helpful Tip: Be specific in the optional instructions area. You can also refer to your Letter to Loved Ones here.

Section 4: Prehospital Medical Care Directive (DNR)

What it does: A Do Not Resuscitate order for EMS and first responders — tells them not to perform CPR if your heart or breathing stops.

To complete:

• Fill in your personal info

• Sign the form

• Have it signed by a licensed Arizona health care provider OR your legal representative

Important: Must be printed on orange or brightly colored paper to be valid in the field.

Section 5: Mental Health Care Power of Attorney

What it does: Allows your agent to make mental health treatment decisions if a court declares you incapacitated.

You can:

• Specify the kinds of treatment you agree to (e.g., inpatient care, medication)

• Include restrictions (e.g., no electroconvulsive therapy)

• Provide guidance for your agent

Signatures required:

• Your signature

• A notary or two witnesses

Helpful Tip: Use this form if you’ve been diagnosed with a condition like schizophrenia, bipolar disorder, or dementia—or if you simply want to be proactive.

Section 6: Arizona Health Care Directives Registration Agreement

What it does: Lets you register your completed documents with the Arizona Advance Directive Registry (AZHDR) so health care providers can find them in an emergency.

You’ll need to:

• Fill in your name and contact info

• Choose what documents you’re submitting

• Sign and submit either by mail, fax, or upload through the portal

🔗 Register your directives online at azhdr.org

✅ After You Complete the Packet

• Review and Sign Forms Properly Some forms require witnesses or a notary. Do not skip this step—documents aren’t valid without proper signatures.

• Make Copies

  • Keep the original in a safe but accessible place

  • Give copies to your agent, doctor, and any hospital or care facility

  • Post your DNR on the fridge or near your bed

• Register the Documents (optional but recommended)

  • Submit through azhda.org

  • You’ll receive a card to keep in your wallet so emergency responders can find your info

• Review Annually or After Major Life Changes

  • Update your documents if you move, divorce, are diagnosed with a serious illness, or if your wishes change

  • You can revoke or replace forms at any time

🛠️ Need Help?

Helpful can guide you through this packet, help you find a notary or witnesses, and store your forms securely. Let us know if you’d like personalized support for yourself or a loved one.