Your Health Care. Your Choice!
Who Is Your Health Care Agent?
Choose a Health Care Agent and complete a Health Care Proxy.
Starting at 18 years old, you can choose a trusted person to be your Health Care Agent.
If you get sick and can not make care decisions yourself, even for a short time while you get better, your Health Care Agent can step in with the power to talk with your doctors and make decisions to get you the care you want. You appoint your Health Care Agent in a document called a Health Care Proxy. Print a free Health Care Proxy below.
You can do it yourself!
1. Choose a person you trust, like a family member, a friend, or anyone you like to be your Health Care Agent.
2. Print a free Health Care Proxy document. (In 15 languages.) Write in the name of your Health Care Agent and complete the form.
3. Give a copy of your Health Care Proxy to your doctors and care providers. They can call your Health Care Agent in an emergency.
4. Make your own “I Have a Health Care Proxy” Wallet Card. (In 4 languages.)
What if your are not able to choose a Health Care Agent?
No Agent? That's Ok. You can write down your care preferences in a document called a Personal Directive or Living Will, and share it with your doctors and care providers to get good care that is right for you.
Print a Health Care Proxy, Wallet Card, and Personal Directive.
Health Care Proxy
English - English
Español - Spanish
Português - Portuguese
Tiếng Việt - Vietnamese
Kreyòl Ayisyen - Haitian Creole
Kiswahili - Swahili
नेपाली - Nepali
简体中文 - Simplified Chinese
Tagalog - Tagalog
Русский - Russian
繁體中文 - Traditional Chinese
عربي - Arabic
ភាសាខ្មែរ - Khmer
Shqip - Albanian
Polish- Polski
Wallet Card
"I Have a Health Care Proxy" wallet card in 4 languages
Español -Spanish
Português - Portuguese
繁體中文 -Traditional Chinese
Personal Directive (Living Will)
Accessibility
- Screen reader accessible: Use screen reader and fill-able online documents. Learn more.
Your Organization Can Join the Simple Step Campaign!
Help every adult take a simple step to complete a Health Care Proxy.
The Massachusetts Health & Hospital Association, Honoring Choices and leading cross-continuum organizations have come together to help every adult start a simple conversation to choose a Health Care Agent and complete a Health Care Proxy. (In 15 languages). If adults are not able to choose a Health Care Agent, offer a Personal Directive (Living Will) to write down their care preferences and share with their care providers. (In 5 languages).
It's easy to add the Simple Step Campaign to your health care and community organization's workflow. We provide the no cost Simple Step campaign materials, Honoring Choices multi-lingual planning documents and tool kits, and a 30 minute staff training to confidently engage adults in simple conversations. All community groups and health care systems are very welcome. Let's help ensure equal access to planning for every adult in the Commonwealth.
