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Statement of Choices form

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

An advance care plan, including the Statement of Choices, 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

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 document, give your views based on what you believe is in the person's best interests, taking into account their expressed wishes and the views of their significant others. Include the person's doctor and other decision-makers in the process to ensure the document 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) document 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

Last updated 20 April 2018
Last reviewed 22 May 2017

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