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Advance Care Planning Pack

Complete pack: ADRT, Advance Statement, Mental Health Statement & LPA Guidance

👤 Your Personal Details

Found on prescriptions, hospital letters, or your GP records

🏥 GP & Healthcare Details

💡 It's important your GP has a copy of your Advance Care Planning documents so they can be accessed when needed.

📞 Emergency Contacts & People to Notify

⚕️ Advance Decision to Refuse Treatment (ADRT) ? An ADRT is a legally binding document that lets you refuse specific medical treatments in advance, for a time when you may lack the mental capacity to make or communicate decisions.

⚠️ Important Legal Requirements: An ADRT refusing life-sustaining treatment must be: (1) in writing, (2) signed by you, (3) signed by a witness, and (4) include a statement that it applies "even if life is at risk."
⚠️ Life-Sustaining Treatment Declaration: By selecting treatments above, I confirm that this advance decision applies to those treatments EVEN IF MY LIFE IS AT RISK as a result of refusing them.

📝 Advance Statement (Wishes & Preferences) ? An Advance Statement is NOT legally binding but healthcare professionals must consider it. It describes your wishes, preferences, beliefs and values to guide decisions about your care.

💡 Unlike an ADRT, an Advance Statement is not legally binding. However, healthcare professionals have a duty to consider it when making decisions in your best interests.

🧠 Mental Health Advance Statement ? This section lets you record your preferences for mental health treatment if you experience a mental health crisis and lack capacity to make decisions. It's not legally binding but must be considered.

📋 Lasting Power of Attorney (LPA) Guidance ? An LPA lets you appoint someone to make decisions on your behalf if you lose mental capacity. This section provides information and helps you record your intentions.

About LPAs: There are two types of LPA: (1) Health and Welfare - for healthcare and personal welfare decisions, and (2) Property and Financial Affairs - for money and property decisions. LPAs must be registered with the Office of the Public Guardian to be valid.
📌 Recommendation: We strongly recommend creating a Health and Welfare LPA alongside your Advance Care Planning documents. Without an LPA, healthcare decisions will be made by medical professionals in your "best interests" with no legal requirement to consult family members.

✍️ Declaration & Document Date

Recommended: Review annually or after significant health changes
Declaration: By generating these documents, you are declaring that:
  • You are 18 years of age or over
  • You have the mental capacity to make these decisions
  • You are making these decisions voluntarily, without pressure
  • You understand the implications of refusing treatment (for ADRT)

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✓ ADRT (Legally Binding)
✓ Advance Statement
✓ Mental Health Statement
✓ LPA Guidance
✓ Word & PDF Formats
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