Advanced Care Planning - evaluation

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* 1. What is your understanding of an Advance Care Plan? (example: End of life, it is also about taking control of your health journey)

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* 2. Do you have an Advance Care Plan? (example: Everyone knows what is important to you)

Yes

No

Unsure

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* 3. What is your understanding of a Medical Treatment Decision Maker?
(example: Someone you trust that makes decisions to consent or refuse medical treatment)

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* 4. What is your understanding of a Values Directive?
(example: What is important to you, your health, family, community and or country)

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* 5. What is your understanding of an Instructional Directive?
(example: Legal document signed off by the doctor, giving or refusing medical treatment)

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* 6. Your name/contact phone number (optional)