Who Is Your Health Care Agent?
Quick Start helps you choose a Health Care Agent and complete a Health Care Proxy document. Download no cost tools. View helpful videos!
Starting at 18 years old, you can make your own health care choices, and write down your choices in a personal plan.
A good place to start your plan is by choosing a trusted person to be your Health Care Agent and completing a Heath Care Proxy document.
If you get sick and are not able to make care decisions yourself, even for a short time while you get better, your Health Care Agent can step in with the power to talk with your doctors and make decisions to get you the care you want. You appoint or write your Health Care Agent's name in a document called a Health Care Proxy.
Now's the time to complete a Health Care Proxy so it is in place when you need it!
Click on these links to see popular resources on this page:
Watch the VIDEO: Choosing an Health Care Agent.
Watch the short video or follow the 3 simple steps to choose a Health Care Agent, complete a Health Care Proxy document, and share your competed Health Care Proxy with your doctors and care team.
Click this image to view the video.
1. CHOOSE a person you trust, like a family member, a friend, or anyone you like to be your Health Care Agent.
- Talk to your trusted person about your care preferences.
2. WRITE the name of your Health Care Agent in the Health Care Proxy document.
- Print a free Health Care Proxy document below (available in 15 languages.)
- Fill out the document. See video: How To Complete an Honoring Choices Health Care Proxy.
- Give a completed copy to your Health Care Agent.
3. SHARE a copy of your Health Care Proxy with your doctors and medical care team to place into your medical record.
- Your medical team will contact your Health Care Agent in an emergency.
Once you completed your Health Care Proxy-
Make your own “I Have a Health Care Proxy” Wallet Card. (available in 4 languages.) Download the wallet card template below.
What if your are not able to choose a Health Care Agent?
No Agent? That's Ok.
You can write down your care preferences in a document called a Personal Directive or Living Will, and share it with your doctors and care team to get good care that is right for you. Download the Personal Directive below.
Who is Your Health Care Agent? Consumer Handout
Help adults in your community access a free Health Care Proxy! You can distribute the multilingual consumer handout anywhere adults gather, live and receive care.
The 1-page consumer handout (pictured here) offers accurate information on choosing a Health Care Agent and completing a Health Care Proxy. The handout links to the Quick Start page to download a free multi-lingual Health Care Proxy document and view the "how to" videos.
The MA Department of Public Health has partnered with Honoring Choices MA and Massachusetts Health & Hospital Association to promote a statewide Health Care Proxy Campaign, using the Who is Your Health Care Agent? consumer handout and planning documents. Read here.
Everyone can print the handout and distribute widely at your organizations, community events, faith based and affinity groups and any place adults gather, live, and receive care. If you'd like to co-brand the consumer handout with your logo and QR code, contact Ellen, edipaola@honoringchoicesmass.com
The handout is available in 9 languages-
Print a Health Care Proxy, Wallet Card, and Personal Directive (Living Will). View helpful videos.
Health Care Proxy
Español - Spanish
Português - Portuguese
Tiếng Việt - Vietnamese
Kreyòl Ayisyen - Haitian Creole
Kiswahili - Swahili
नेपाली - Nepali
简体中文 - Simplified Chinese
Tagalog - Tagalog
Русский - Russian
繁體中文 - Traditional Chinese
عربي - Arabic
ភាសាខ្មែរ - Khmer
Shqip - Albanian
Polish- Polski
Accessibility
Screen reader accessible: Use screen reader and fill-able online documents. Learn more.
Short Videos
Watch How To Complete an Honoring Choices Health Care Proxy (English)
Watch Who is Your Health Care Agent?: Choosing a trusted person to be your Health Care Agent.
Wallet Card
Personal Directive (Living Will)
Join the statewide Health Care Proxy Campaign!
The MA Department of Public Health's Health Care Proxy Campaign helps to ensure equal access to care planning information and documents for everyone in the Commonwealth.
The MA Department of Public Health has partnered with Honoring Choices MA and Massachusetts Health and Hospital Association (MHA) to support a statewide Health Care Proxy Campaign, using the Honoring Choices Who is Your Health Care Agent? consumer handout and no cost multilingual planning documents and tools. Read announcement.
Whether you are a consumer, a community group or organization, you can download and share the free Who Is Your Health Care Agent? consumer handout anywhere adults live, receive care, and gather! Every handout links to the Quick Start page to access a free multilingual Health Care Proxy and other tools. Groups can co-brand the multilingual consumer handouts with their organization’s logo and QR code to tailor to their community. For more information, contact Ellen, edipaola@honoringchoicesmass.com
Here are some of the ways our Partners & Friends are distributing the multilingual consumer handout:
- MHA Simple Step Campaign, supporting MA Hospitals and Key Cross-Continuum Care Partners (Read more below)
- "Take a simple step" to engage patients to complete a Health Care Proxy and Personal Directive (Living Will).
- Sturdy Hospital, supporting their South Shore Patients, Primary Care, Risk Management, Care Management professionals.
- Co-branded consumer handouts and the HCM Health Care Proxy in English, Spanish, Portuguese, Haitian-Creole, Arabic.
- City of Lynn Public Health Division, Flu Clinics & Community Events.
- Co-branded consumer handouts in English, Spanish, Haitian-Creole, Khmer.
- Abington Public Health Department, Flu Clinics & Community Events.
- Co-branded consumer handout in English, Portuguese, Haitian-Creole, Vietnamese.
- Nantucket Palliative & Supportive Care, Patents & families and Community Events.
- Distributing consumer handouts and HCM Getting Started Tool Kit.
- LifePath, Berkshire Consumer Healthy Living Workshops
- AgeSpan, North Shore Housing Program Residents
- Consumer’s offering the consumer handouts at their faith-based and community groups.
We are just getting started! Let us know how you are supporting adults in your community.
MHA's Simple Step Campaign: Cross-Continuum Initiative
Your organization can help adults take a simple step to complete a Health Care Proxy.
The Massachusetts Health & Hospital Association (MHA), Honoring Choices and leading cross-continuum organizations have come together to support the Simple Step Campaign, to engage every adult in a simple conversation to choose a Health Care Agent and complete a Health Care Proxy. If adults are not able to choose a Health Care Agent, care professionals can offer a Personal Directive (Living Will). The Personal Directive helps adults write down their care preferences and share with their care providers.
It's easy to include the Simple Step Campaign to your organization's workflow. MHA provides the no cost Simple Step campaign materials, Honoring Choices multi-lingual planning documents and tool kits, and a 30 minute staff training to confidently engage adults in simple conversations.
Join us! All community groups and health care systems are very welcome to join the campaign. Let's ensure every adult across the Commonwealth has early and equal access to health care planning.
