Life Care Planning Forms


Now that you have thought about Life Care Planning and discussed certain topics with those who can help you complete the forms, decide which forms you want to sign, and what you want to say in each form. Then read the instructions on each form and follow all instructions exactly, especially as to signing and witnesses. Each form has different requirements for completion under Arizona law, so be sure you follow all the individual instructions on each form.

You do not need an attorney to help you complete the forms. The forms are available at no cost to you by:

  • Downloading the complete packet or individual forms below.
  • Visiting the Attorney General's Phoenix and Tucson offices, or one of several Satellite Offices for copies.
  • Completing a Life Care Planning request form or calling (602) 542-2123 or (800) 352-8431 to have them mailed to you.
(The Life Care Planning forms available on this website are courtesy of the Office of the Attorney General of Arizona, Mark Brnovich.)
 
Form Title Form No.
Life Care Planning Forms - Complete Packet AZAG PBGN1PKT
Checklist  AZAG PBGN2K
Registration Agreement* AZAG PBGN3F
Durable Health Care Power of Attorney*
 AZAG PBGN4F
Durable Mental Health Care Power of Attorney* AZAG PBGN5F
Living Will (End of Life Care)* AZAG PBGN6F
Letter to my Representative(s) (or Agent) About Powers of Attorney Forms and Responsibilities AZAG PBGN7F
Prehospital Medical Care Directive (Do Not Resuscitate)* - NOTE: This form must be printed on orange paper AZAG PBGN8F
 *Indicates forms that can be registered with the Secretary of State's Office
 

The Advance Directive Registry at the Arizona Secretary of State's Office is a free registry to electronically store and access your medical directives. The secure and confidential program grants peace of mind to registrants and their families, and easy access to all health care providers. To register your completed documents, make photocopies and send the copies to: 

Arizona Secretary of State
Attn: Advance Directive Dept.
1700 W. Washington St.
Phoenix, AZ 85007

Additional filing information is available at the Secretary of State's Advance Directive Registry webpage.