Forms, Tools, and Websites

Click on the text in blue to be connected to the website or resource.
Woman-with-TeaNational POLST Website: Up to date information on the POLST Paradigm from a national perspective with numerous resources, publications, and educational materials.
Caring Connections: comprehensive Web resource on advance care planning and caregiving. Advance directive forms and instructions for every state can be downloaded from this site.
The Conversation Project:  a website resource and social networking site intended to encourage and facilitate discussions and documentation of advance care planning.
The Your Right to Make Healthcare Decisions booklet describes the Colorado advance directive forms in clear, plain language. Forms for Living Will, Medical Power of Attorney, and CPR directive are included. (Note: This version, dated January 2011, is the most current and replaces the old “yellow booklet.”)

Simple Medical Durable Power of Attorney appointment document.

Colorado General Power of Attorney form to appoint a general power of attorney for purposes of handling financial or other matters NOT related to healthcare.

Colorado Declaration of Disposition of Last Remains: needed to document preferences for handling of your body after death and any memorial service.

Simple Living Will form with updates according to 2010 Living Will revisions. Summary of revisions to the Living Will form from 2010 Colorado Legislative session.

Summary of revisions to the CPR regulations and CDPHE Template form.

Facts About CPR —  A helpful patient-family information sheet on the actual outcomes and risks of CPR for older, seriously ill, or frail individuals.

Daughter-FatherColorado Department of Public Health and Environment revised regulations for the Colorado CPR Directive.

Simple form for documentation of a Proxy by Statute selection.

Comparison Chart of Advance Directives (updated 7/2016), including Living Will, MDPOA, CPR directive, Designated Beneficiary, Medical Orders for Scope of Treatment, and Guardianship.

Chart outlining which advance care planning document prevails in a variety of circumstances

Advance Care Planning Flowchart for consumers.

Advance Care Planning Flowchart for healthcare providers.

HIPAA Release Form — use this form to authorize another person to look at your medical records and talk to your health care providers about your condition.

For active folks with CPR directives, a special no-CPR bracelet or necklace can be obtained from Award and Sign Connection (visit their website or 303.799.8979) or MedicAlert Foundation (visit their website or 888.633.4298).

National Hospice Locator: a database with detailed information on all hospice agencies in the country, including links to websites, contact information, and agency characteristics.

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Colorado Bar Association’s Senior Law Handbook 2016: contains valuable information on many legal topics for seniors including real estate transactions, avoiding identity theft, estate planning, medical directives and advance care planning, options for care at the end of life.

Aging with Dignity (Five Wishes): Aging with Dignity is a national non-profit organization with a mission to affirm and safeguard the human dignity of individuals as they age and to promote better care for those near the end of life.

Dying in America: Improving Quality and Honoring Individual Preferences at the End of Life, a September, 2014, report by the Institute of Medicine.

Coding and Billing Resources For Providers:
As of August 1, 2013, Medicaid coverage of end-of-life counseling by primary care providers and other specialty providers caring for Medicaid beneficiaries with serious, chronic, or terminal illness relating to the Medical Orders for Scope of Treatment (MOST) is available. Click here for details.
As of January 1, 2016, Medicare will reimburse for advance care planning conversations! See this handout on Medicare billing for Advance Care Planning for details.