It is important that your medical treatment be your choice.

The purpose of this form is to assist you in thinking about and writing down what is important to you about your health. If you should at some time become unable to make health care decisions, this form may help others make a decision for you in accordance with your values.

The first section of this form provides an opportunity for you to discuss your values, wishes, and preferences in a number of different areas such as your personal relationships, your overall attitude toward life, and your thoughts about illness.

The second section of this form provides a space for indicating whether you have completed an Advance Directive, e.g., a Health Care Proxy & Living Will, and where such documents may be found.

 

 CLICK HERE FOR A COPY OF THE VALUES HISTORY FORM