BENEFICIARY SERVICES

215 West Loucks Street

Sheridan, Wyoming 82801-4226

Phone: (307) 459-4653 Fax: (413) 751-9511

We Are Here To Help You Make The Most Of Your Estate Plans

For Additional Information and Pricing Please Contact Your Equity Planner

Planning for Important Healthcare Decisions

Learn about options for end-of-life services and care

Implement plans to ensure wishes are honored

Voice decisions to family, friends and health care providers

Engage in personal or community efforts to improve end-of-life care

Your Advance Care Planning Packet

Using these Materials

Summary of the HIPAA Privacy Rule

Introduction to Your State Advance Directive

Instructions for Completing California Care Directive

You Have Filled Out Your Advance Directive, Now What?

Glossary of Terms about End-of-Life Decision-making

Legal & End-Of-Life Care Resources Pertaining to Health Care Advance Directives

Using These Materials

BEFORE YOU BEGIN

Check to be sure that you have the materials for each state in which you could receive health care.

These materials include:

	Instructions for preparing your advance directive.
	Your state-specific advance directive forms.

PREPARING TO COMPLETE YOUR ADVANCE DIRECTIVE

Read the HIPAA Privacy Rule Summary.

Read all the instructions, as they will give you specific information about the requirements in your state.

Refer to the Glossary of Terms About End-of-Life Decision-making if any of the terms are unclear.

ACTION STEPS

You may want to photocopy these forms before you start so you will have a clean copy if you need to start over.

Talk with your family, friends, and physicians about your advance directive. Be sure the person you appoint to make decisions on your behalf understands your wishes.

Once the form is completed and signed, photocopy the form and give it to the person you have appointed to make decisions on your behalf, your family, friends, health care providers and/or faith leaders so that the form is available in the event of an emergency.