Forms |Advance Care Planning Forms

QHN Supports Advance Care Planning

QHN is pleased to help support a patients' right to make healthcare decisions by providing access, via the QHN HIE, to Advance Care Planning documents across the continuum of care.

Mesa County Advance Care Planning (ACP) Workgroup

QHN is proud to be a partner in the Mesa County ACP workgroup which is part of the Colorado Health Foundation's three-year initiative designed to accelerate existing ACP efforts in Colorado and support innovative ACP demonstration projects. The initiative's goal is to: Increase individual and family health engagement through advance care planning.

The Mesa County project has developed and gained broad community consensus on the utilization of the Emergency Response Wishes form to be used in all advance care planning settings. Encouraging providers to upload ACP documents into the QHN system allows these critical documents to be accessed across the continuum of care.

Advance Care Planning Resources and Forms

The booklet Your Right to Make Health Care Decisions is provided through the The Colorado Hospital Association as a public service to the community.

This booklet informs you about your right to make healthcare decisions, including the right to accept or refuse medical treatment. It provides you with ready-to-use forms on which to record your decisions about medical treatment and your choice of the person you want to make decisions for you when you cannot.

These forms, and any written instructions you make ahead of time about your medical treatment, are called advance directives. The booklet explains the following advance directives and related subjects:
  • Medical Durable Power of Attorney for Healthcare Decisions
  • Living Will (Advance Directive for Surgical / Medical Treatment)
  • CPR Directive
Download the Your Right to Make Health Care Decisions Booklet

Colorado Advance Directives Consortium

The Colorado Advance Directives Consortium (CADC) is an informal organization of professionals in healthcare, senior services, law, and ethics dedicated to improving the tools and processes for healthcare decision making in Colorado.

Since 2006, the CADC has played key roles in revising the Colorado CPR directive regulations and the Living Will statute, and launching the Medical Orders for Scope of Treatment (Living Will) program.

The CADC works with other stakeholder organizations to offer education on advance directives and related topics to emergency medical responders, long-term care facilities, hospitals, home health, and hospice agencies. Their website is an excellent resource for advance directive information, forms and educational opportunities.

Visit the CADC website.
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