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📋

Welcome to Your Advance Care Planning Pack

This will guide you through creating your advance care documents. First, would you like to include an Advance Decision to Refuse Treatment (ADRT)?

What is an ADRT? A legally binding document that lets you refuse specific medical treatments in advance, for a time when you may lack capacity to decide.
Yes, Include ADRT I want to make legally binding treatment refusals
➡️ Skip ADRT I'll just complete the Advance Statement
👤

What is your full legal name?

As it appears on official documents

🎂

What is your date of birth?

You must be 18 or over to make these documents

🏠

What is your current address?

Your full residential address

🏥

Who is your GP?

Your GP should have a copy of these documents

📞

Who should be contacted in an emergency?

Your primary emergency contact

📱

Do you have a secondary contact?

A backup person to contact (optional)

⚕️

Which treatments do you want to refuse?

Select all treatments you wish to refuse if you lack capacity

⚠️ Important: These refusals are LEGALLY BINDING. Only refuse treatments you truly do not want, even if your life is at risk.
📋

When should your ADRT apply?

Select the circumstances when you want to refuse treatment

🏠

Where would you prefer to be cared for?

If you become seriously ill or are nearing end of life

🏠 At Home
🏥 In a Hospice
🏨 In Hospital
🏡 In a Care Home
🕊️

Where would you prefer to die?

This is a preference, not always possible to guarantee

🏠 At Home
🏥 In a Hospice
🏨 In Hospital
🤷 No Preference
💊

How would you like pain to be managed?

Your preference for balancing pain relief and awareness

😴 Maximum Relief Even if it affects my awareness
⚖️ Balanced Relief while maintaining some awareness
👁️ Stay Alert Minimal medication to stay aware
💝

What matters most to you?

Your values and what brings you comfort

🧠

Include a Mental Health Statement?

Record preferences for mental health crisis care

A Mental Health Advance Statement records your preferences for treatment if you experience a mental health crisis and lack capacity to decide.
Yes, Include I want to record MH preferences
➡️ Skip Not relevant for me
🧠

Mental Health Preferences

Information to help during a mental health crisis

📋

Do you have a Lasting Power of Attorney?

An LPA lets someone make decisions if you can't

Recommended: A Health & Welfare LPA works alongside your ADRT to ensure your wishes are followed.
Yes, I Have One Already registered
No LPA Yet Haven't created one
In Progress Pending registration
📌 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.
📅

When is this document dated?

The official date of your advance care planning documents

💡 Review your documents annually or after any significant change in your health.

Your Advance Care Planning Pack is Ready

Review your customized documents below

Remember to give copies to your GP, family members, and keep one with you.

Instant Access

Unlock Your Documents Now

Get instant access to both Interview and Editor versions

ADRT (Legally Binding)
Advance Statement
Mental Health Statement
LPA Guidance
Word & PDF Formats
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£22
One-Time Payment
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Email [email protected] within 30 days with your order number.

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