Before Completing a HCP

FAQ
  • What is a Health Care Proxy (HCP)?
    • A Health Care Proxy is a form that gives the person you decide upon ability to speak for you medically if you are not able to communicate for yourself,
    • it is a one page form and takes approximately 3 minutes to fill out, and
    • requires two adults, other than the health care agent, to witness and sign.

  • Who needs a HCP?
    • Everyone over the age of 18.

  • What to do before completing a HCP form.
    • choose someone
      • you trust 
      • is willing to act as your health care agent, and
      • is 18 years or older.
    • discuss what types of treatments you would or would not want in a life threatening situation including, but not limited to, artificial nutrition and hydration.
    • decide what aspects of your life you are not willing to compromise on, what brings you joy, and what you want to accomplish.
    • This is not a complete list of what to do before completing a HCP form. Please visit https://www.health.ny.gov/forms/doh-1430.pdf

  • What to bring to facilitate completion of a HCP:
    • your photo ID, and
    • name, address and phone number of your Health Care Agent(s).

For more information go to:
To print out a free Health Care Proxy go to http://www.health.ny.gov/forms/doh-1430.pdf

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