Skip links and keyboard navigation

Queensland advance care planning forms

Advance care planning documents will only be used if a person is unable to make or communicate their decisions. People can change their mind, their plans, their Statement of Choices and legal documents at any time while they have decision-making capacity to do so.

Download the Statement of Choices form

The Statement of Choices form focuses on a person’s wishes and choices for health care into the future.

Statement of Choices Form A

Statement of Choices Form A—for people who can make their own health care decisions.

It is a good idea to include your doctor, family, and substitute decision-maker/s in the process to ensure they understand your wishes.

Tips for how to complete Form A

Statement of Choices Form A

Statement of Choices Form B—for people who cannot make their own health care decisions or who require support with decision-making.

If you are the substitute decision-maker, when completing the form, give your views based on what you believe is in the person's best interests, taking into account their previously expressed wishes and the views of their significant others. Include the person’s doctor and other decision-makers in the process to ensure the form most completly reflects the person’s values.

Tips for how to complete Form B

Statement of Choices Form A
 
The Statement of Choices is a values based advance care planning (ACP) form used throughout Queensland. To download the Statement of Choices from your local health service area, enter the suburb or postcode of your Queensland residence or Queensland based health service.

Please enter your suburb or postcode

Important

New Advance Health Directive (AHD) and Enduring Power of Attorney (EPOA) forms have been approved for use in Queensland from 30 November 2020.

  • Forms to be completed on or before 29 November 2020 - use the current AHD/EPOA forms linked below (on this page).
  • Forms to be completed after 30 November 2020 - use the new AHD/EPOA forms.

If an AHD or EPOA was made correctly using an older version of the form and it was valid, it will continue to be valid. For more information, please read these Frequently Asked Questions about the new EPOA and AHD forms and when you should use them.

The Office of Advance Care Planning has developed an Information sheet (PDF, 140.78 KB) highlighting what has changed with the AHD and EPOA forms.


Download the Advance Health Directive form

Advance Health Directive

Advance Health Directive form--for people who have decision-making capacity.

 

Download an Enduring Power of Attorney form

Enduring Power of Attorney short form

Enduring Power of Attorney short form--Used if you have decision-making capacity and wish to appoint the same attorney for health and financial matters.

Enduring Power of Attorney long form

Enduring Power of Attorney long form--Used if you have decision-making capacity and wish to appoint different attorneys for health and financial matters.


Download the Interpreter's/Translator's Statement form

Interpreter's/Translator's Statement form

Interpreter's/Translator's Statement form--used if an interpreter/translator is involved in the signing of an Advance Health Directive or Enduring Power of Attorney document.


Download the Revocation of an Enduring Power of Attorney form

Revocation of an Enduring Power of Attorney form

Revocation of an Enduring Power of Attorney form--Used if you have decision-making capacity and wish to revoke (cancel) the appointment of a person or persons as your attorney(s).

Last updated 3 November 2020
Last reviewed 4 December 2018

Page feedback

Contact (optional)

Please provide your phone number or email address if you are happy for us to contact you with any follow-up questions.