Advance Care Planning

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�۰�ͼ�� and the �۰�ͼ�� Center for Healthcare Ethics are offering the community the opportunity to complete their Advance Care Plan (Advance Directive) and register it, free of charge, with our national Advance Directive Registry through the U.S. Living Will Registry. Wherever you go in the United States your Advance Care Plan will be accessible by healthcare professionals when needed to guide your medical care if you are unable to communicate your wishes or make your own decisions.

Advance Care Plan (Advance Directive) documents can include your Living Will, which helps the health care team know what your wishes are, and your Medical Power of Attorney or Healthcare Agent, which is who you want to speak for you if you can't speak for yourself.

You can appoint any adult over the age of 18 to be your healthcare agent, including your spouse, your same-sex or domestic partner, an adult child, a family member, a friend, or any other adult you trust.

There are many ways to submit your Advance Care Plan (Advance Directive) documents to �۰�ͼ��care.

Give them to your Primary Care Physician
Upload them to MyChart
Take them to the nearest �۰�ͼ�� hospital Medical Records Department
Mail, fax, or call to schedule an appointment to bring the document in person to:

�۰�ͼ�� Center for Healthcare Ethics
350 Centre Pointe Drive
Virginia Beach, VA 23462
Phone: 757-252-9550
Fax: 757-965-2804
Email: �۰�ͼ��Ethics@sentara.com

Resources

Advance Care Planning Guide

Please take the time to read this guide with information on Advance Care Planning in a question and answer format. Read additional information that may help you fill out your care plan.

Documents

Virginia ACP Form / North Carolina ACP Form
If you wish to complete your Advance Care Plan (Advance Directive) online, you may do so, then save and print this form. Or if you wish, simply print the form and complete it by hand.

Versión en Español

Registration Agreement
If you already have an Advance Care Plan (Advance Directive and would like to have it registered, these forms contain a Registration Agreement and complete instructions on where to send your Advance Care Plan and to have it registered with the U.S. Living Will Registry. Print this form, complete it and follow the instructions on the information sheet.

Patient Protest Attachment - Virginia ONLY
Use only if you want to give your Healthcare Agent the right to override your protest should you protest treatment decisions after being declared to lack decisional capacity by your physician. Call the �۰�ͼ�� Center for Healthcare Ethics at 757-252-9550 if you need assistance or have more questions reference this provision.

Patient Life Sustaining Treatment During Pregnancy Attachment - Virginia ONLY
If you wish to provide additional instructions or modifications to instructions you have already given regarding life-prolonging procedures that will apply if you are pregnant at the time your attending physician determines that you have a terminal condition, you may do so by completing this Attachment and attaching it to your Advance Care Plan. Call the �۰�ͼ�� Center for Healthcare Ethics at 757-252-9550 if you need assistance or have more questions reference this provision.

Advance Care Planning Presentations

The �۰�ͼ�� Center for Healthcare Ethics provides community service presentations to religious, spiritual or civic groups interested in learning more about Advance Care Planning. If you have any questions, please contact the center for assistance at 757-252-9550.

Have questions or need assistance with your Advance Care Plan?

Always discuss your Advance Care Plan with your Primary Care Physician.

Assistance is also available from the �۰�ͼ�� Center for Healthcare Ethics (757-252-9550 or �۰�ͼ��Ethics@sentara.com) or from Chaplaincy Services at your nearest �۰�ͼ�� hospital.

If you would like help completing your Advance Care Plan, �۰�ͼ�� provides Certified Advance Care Planning Facilitators. To schedule your appointment, please call the �۰�ͼ�� Center for Healthcare Ethics at 757-252-9550 or email us at �۰�ͼ��Ethics@sentara.com.

Location

�۰�ͼ�� Center for Healthcare Ethics
350 Centre Pointe Drive
Virginia Beach, Virginia 23462

Watch a video about Advance Care Planning