Who Is Your Health Care Agent?
It's quick and easy to choose a Health Care Agent and complete a Health Care Proxy document. Download no cost tools. View helpful videos!
Starting at 18 years old, you can make your own health care choices and write down your choices in a personal plan.
A good place to start your plan is by choosing a trusted person to be your Health Care Agent and completing a Heath Care Proxy document.
If you get sick and are not able to 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 or write your Health Care Agent's name in a document called a Health Care Proxy.
Not able to choose a Health Care Agent? That's OK. Start to make a plan with a Personal Directive or Living Will document. You can write down your care preferences and share with your health care providers to get care that is right for you. See documents below.
Quick Start Resources & Joint Initiatives:
Watch the Video: Choosing a Health Care Agent
Complete a Health Care Proxy (15 languages)
Share the Who Is Your Health Care Agent? Consumer Handout
Join the MA Health & Hospital Association's Simple Step: Cross-Continuum Initiative
Be a Trusted Source of Information in Your Community. Join the MA DPH Health Care Proxy Campaign
Watch the VIDEO: Choosing a Health Care Agent.
Watch the short video and follow the 3 simple steps to choose a Health Care Agent, complete a Health Care Proxy document, and share your competed Health Care Proxy with your doctors and care team.
English
Spanish (Latin) Translation
Portuguese (Brazil) Translation
Traditional Chinese Translation
1. CHOOSE a person you trust, like a family member, a friend, or anyone you like to be your Health Care Agent.
- Talk to your trusted person about your care preferences. See video: Choosing a Health Care Agent.
2. WRITE the name of your Health Care Agent in the Health Care Proxy document.
- Print a free Health Care Proxy document below (available in 15 languages.)
- Fill out the document. See video: How To Complete an Honoring Choices Health Care Proxy.
- Give a completed copy to your Health Care Agent.
3. SHARE a copy of your Health Care Proxy with your doctors and medical care team to place into your medical record.
- Your medical team will contact your Health Care Agent in an emergency.
Once you completed your Health Care Proxy-
Make your own “I Have a Health Care Proxy” Wallet Card. (available in 4 languages.) It helps medical staff call your Health Care Agent in an emergency. Download below.
What if you are not able to choose a Health Care Agent?
No Agent? That's OK. Start with a Personal Directive or Living Will document. Write down your care preferences and share with your care providers to get care that is right for you.
Personal Directive (Living Will)
Who is Your Health Care Agent? Consumer Handout
Help adults in your community access a free Health Care Proxy! You can co-brand the multi-lingual consumer handouts with your group's logo and QR code, and distribute anywhere adults gather, live and receive care.
Everyone can print the free multi-lingual consumer handout and distribute to adults in your community!
The Who is Your Health Care Agent? handout (pictured here) offers accurate information on choosing a Health Care Agent and completing a Health Care Proxy. The handout's QR code links to the Honoring Choices MA Quick Start page to download a free multi-lingual Health Care Proxy document and view "how to" videos.
The MA Department of Public Health has partnered with Honoring Choices MA and Massachusetts Health & Hospital Association to promote a statewide Health Care Proxy Campaign using the Who is Your Health Care Agent? consumer handout and planning documents. Read here.
You can co-brand the multi-lingual consumer handout with your group's logo and add your QR code. Choose the languages best for your community. Contact Ellen, edipaola@honoringchoicesmass.com
The handout is available in 9 languages-
Download Multilingual Documents and Tools. Watch Helpful Videos.
Print a no cost Health Care Proxy, Wallet Card, and Personal Directive. Watch helpful videos.
Health Care Proxy
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
Accessibility
Screen reader accessible: Use screen reader and fill-able online documents. Learn more.
Watch Short Videos
Who is Your Health Care Agent?: Choosing a Health Care Agent
Choose a trusted person to be your Health Care Agent and talking about how you want to be cared for over your lifetime.
- English; Subtitles in Spanish, Portuguese, Chinese
How To Complete an Honoring Choices Health Care Proxy
Easy step by step guide to completing your own Honoring Choices Health Care Proxy, signed by two witnesses. (English).
"I Have a Health Care Proxy" Wallet Card
Medical staff can call your Health Care Agent in an emergency.
Español -Spanish
Português - Portuguese
繁體中文 -Traditional Chinese
Tiếng Việt - Vietnamese
Kreyòl Ayisyen - Haitian Creole
Personal Directive (Living Will)
Join the MA Department of Public Health's
Health Care Proxy Campaign!
The MA Department of Public Health's Health Care Proxy Campaign helps to ensure equal access to care planning information and documents for everyone in the Commonwealth.
The MA Department of Public Health
(MA DPH) has partnered with Honoring Choices MA and Massachusetts Health and Hospital Association (MHA) to support a statewide Health Care Proxy Campaign, using the Honoring Choices Who is Your Health Care Agent? consumer handout and no cost multilingual planning documents and tools. Read announcement.
Whether you are a consumer, a community group or organization, you can download and share the free Who Is Your Health Care Agent? consumer handout anywhere adults live, receive care, and gather! Every handout links to the Quick Start page to access a free multilingual Health Care Proxy and other tools. Groups can co-brand the multilingual consumer handouts with their organization’s logo and QR code to tailor to their community. For more information, contact Ellen, edipaola@honoringchoicesmass.com
Be a Trusted Source of Information in Your Community!
Join us- Be a trusted source of health care planning information and distribute the consumer handout and planning documents to adults in your community. Support your staff in engaging adults in simple care planning conversations to choose a Health Care Agent and complete a Health Care Proxy and/or Personal Directive (Living Will).
Here are some of the Honoring Choices Partners & Friends who tailored the tools for their community. We can co-brand the multilingual consumer handouts with your organization’s logo and QR code at no cost. Cost. For more information, contact Ellen, edipaola@honoringchoicesmass.com
MA Health & Hospital Association Simple Step Campaign
All MA Hospitals and Cross-Continuum Professionals
Helps adults to take a simple step to complete a Health Care Proxy & Personal Directive (Living Will).
South Shore Patients, Primary Care & Care Management Staff
Provides co-branded handouts & Health Care Proxy in English, Spanish, Arabic, Portuguese, Haitian-Creole.
Health Clinics, Flu Clinics, and Community Events in Lynn
Provides co-branded handouts in English, Spanish, Haitian-Creole, Khmer.
Dementia Friends MA Champions helping Adults & Families; Community Events
Provides handouts, planning tools; See Dementia Friends MA information flyer (10 languages)
MassNAELA Health Care Proxy Clinics
Brings Mobile Clinics to Community Health Centers
Provides documents & videos: English, Spanish, Portuguese, Haitian-Creole. Clarence Richardson, Clarence@MassNAELA.com
Life Care Managers provide holistic services to navigate the aging journey.
Provides handouts Health Care Proxy & Personal Directive (Living Will).
Greater Springfield Senior Services
Consumer Presentations: "Now's the Time. Make Your Own Care Plan"
Provides adults with the Getting Started Tool Kit, multilingual documents.
Nantucket Palliative & Supportive Care
Adults & families and Community Events
Provides handouts, Getting Started Tool Kit, multilingual documents
LifePath, Western & North Central MA
Berkshire Consumer Healthy Living Workshops; Honoring Choices Ambassadors
Provides handouts, Health Care Proxy, Getting Started Tool Kit.
Your Elder Experts, JF&CS, Jewish Family & Children's Services of Greater Boston
Aging Life Care Managers helping Adults & Families
Provides care planning information and Health Care Proxy.
AgeSpan, North Shore
North Shore Housing Program Residents; Honoring Choices Ambassadors
Provides handouts, Health Care Proxy, Getting Started Tool Kit.
Health Clinics, Flu Clinics, Community Events in Abington
Provides co-branded handouts in English, Portuguese, Haitian-Creole, Vietnamese.
MA Health & Hosptial Association Simple Step: A Cross-Continuum Initiative
Your organization can help adults take a simple step to complete a Health Care Proxy.
The Massachusetts Health & Hospital Association (MHA), Honoring Choices and leading cross-continuum organizations have come together to support the Simple Step Campaign, to engage every adult in a simple conversation to choose a Health Care Agent and complete a Health Care Proxy. If adults are not able to choose a Health Care Agent, care professionals can offer a Personal Directive (Living Will). The Personal Directive helps adults write down their care preferences and share with their care providers.
It's easy to include the Simple Step Campaign to your organization's workflow. MHA provides 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.
Join us! All community groups and health care systems are very welcome to join the campaign. Let's ensure every adult across the Commonwealth has early and equal access to health care planning.