Get Sample Document - Five Wishes

The Five Wishes document serves as an important tool for individuals wanting to outline their healthcare preferences in the event that they cannot communicate them. This guide provides clear instructions on filling out the Five Wishes form online, ensuring that your desires regarding medical treatment and personal wishes are duly recorded.

Follow the steps to fill out the Five Wishes form online.

1. Click ‘Get Form’ button to access the Five Wishes document and open it in your preferred online editor.
2. Begin by filling in your name and birthdate at the top of the form. This identification section ensures that your wishes are correctly associated with you.
3. In the first section, specify your choice for the person you want to make healthcare decisions on your behalf when you are unable to do so. Provide their name, address, and phone number. Include alternatives in case your first choice is unavailable.
4. Outline your medical treatment preferences in Wish 1. Clearly express any medical treatments you want or do not want, considering pain management and life-support measures.
5. In Wish 2, provide detailed instructions regarding how comfortable you want to be during treatment. Select options such as pain relief, personal care, and comfort preferences.
6. Document your wishes in Wish 3 concerning how you want people to treat you. This includes emotional support and physical presence during challenging times.
7. In Wish 4, outline what you want your loved ones to know. This encompasses forgiveness, personal messages, and your desires regarding memorial services and afterlife wishes.
8. Finalize the document by signing it in the presence of two witnesses as required. Their role is to affirm your sound mind and the voluntary nature of the form.
9. After signing, make sure to store the original in an accessible place at home. Share copies with family members, your healthcare agent, and medical providers to ensure they are aware of your wishes.
10. Finally, consider downloading or printing the form for your records. You may also wish to share it with your healthcare provider to include in your medical documentation.

Start completing your Five Wishes document online today to ensure your healthcare preferences are safeguarded.