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As part of our outreach, the Hemlock Society of San Diego attempts to provide information and tools that our members and guests can use in planning their health care and their deaths. Please note the links below may take you to other websites and we try to keep them current; but, if you encounter a broken or bad link, please contact us so we can correct the issue.  Also, please feel free to contact us via email if you’d like to suggest additional forms. We want to make this list as comprehensive and useful as we can. Thank you.

Dementia Directives

Supplemental Advance Directive For Dementia Care – Final Exit Network

Dementia Directive – End of Life Washington

Dementia Advance Directive – End of Life Choices New York

Dementia Provision (Advance Directive Addendum) – Compassion & Choices

Dementia Directive –


Advance Directives:

Advance Health Care Directive Form – Final Exodus

Advance Health Care Directive Form – California Attorney General

Advance Directive Form by State – CaringInfo


Physician Orders for Life-Sustaining Treatment (POLST)

CA POLST Form – POLST California


Covid Form

Corona Virus Specific Addendum to Health Care Directive – Hemlock Society San Diego