ACP in my state or territory

Find the right forms

Forms and requirements for writing advance care plans and appointing substitute decision-makers vary between and states and territories.

Please note: ACPA is not responsible for the maintenance or currency of forms and information on these sites. If you have trouble finding material when you access a link from the ACPA website, please contact the relevant website owner directly (E.g. state government department).

In the Australian Capital Territory, the components of an advance care plan are:

Enduring Power of Attorney

Use this form to legally appoint a substitute decision-maker in the Australian Capital Territory.

Statement of Choices

A person uses the Statement of Choices form to record their wishes regarding medical treatments and procedures.

If a person is no longer to make or communicate their decisions, a substitute decision-maker can fill out a Statement of Choices on the person's behalf, using the No Legal Capacity version.

Health Direction

With the Health Direction form, a person can legally record their future healthcare decisions, including refuse medical treatment generally, or withhold or withdraw treatment of a particular kind. This form is optional.

  • Website

    Advance Care Planning Program (ACT)

    ACT Government

    The Advance Care Planning (ACP) Program in the Australian Capital Territory provides a quality assured system of discussing, recording and documenting a person's healthcare wishes.

  • Form

    Enduring Power of Attorney (ACT)

    ACT Government

    View the form to legally appoint a substitute decision-maker in the Australian Capital Territory.

  • Form

    Advance Care Plan Statement of Choices - Competent Person (ACT)

    ACT Government

    Form for a person able to make decisions to record choices regarding future medical treatments and procedures, to inform a substitute decision-maker and doctor.

  • Form

    Advance Care Plan Statement of Choices - No Legal Capacity (ACT)

    ACT Government

    Form for a substitute decision-maker to record choices regarding medical treatments and procedures for a person unable to make decisions.

  • Form

    Health Direction form (ACT)

    ACT Government

    View the advance care plan form for people living in the Australian Capital Territory, recording decisions for healthcare treatments and procedures.

  • Website

    Chronic Care Program – Advance Care Planning service (ACT)

    ACT Government

    The Chronic Care Program (CCP) has established two Advance Care Planning clinics to assist patients in the Chronic Care Program complete advance care plans.

In New South Wales, the components of an advance care plan are:

Advance Care Directive

New South Wales does not have a specific form for an advance care directive. Your Advance Care Directive should be a written and signed by the person and a witness.

Some local health districts have forms a person may complete in those districts - anyone can use these forms as a template for writing their own advance care directive. You can also write down your wishes in a letter. Make sure to write down specific information relating to your wishes, values, and any treatments you would not wish to receive to inform your doctor and substitute decision-maker. Your form or statement is supported under common law.

This is supported under the Guardianship Act 1987 and has been confirmed by the NSW Supreme Court in 2009 that an Advance Care Directive is legally binding.

Enduring Guardian

As part of your advance care plan, you can legally appoint a substitute decision-maker under the Guardianship Act 1987. The Appointment of Enduring Guardian form is required to choose a substitute decision-maker in New South Wales.

  • Website

    Advance care planning in New South Wales

    NSW Government

    Learn more about advance care planning in New South Wales through the NSW Health website.

  • Form

    Making an Advance Care Directive

    NSW Government

    This package includes an Advance Care Directive form and Information Booklet.

  • Form

    Appointment of Enduring Guardian (NSW)

    NSW Government

    View the form to legally appoint a substitute decision-maker in New South Wales.

  • Form

    Notice of Resignation as Enduring Guardian (NSW)

    NSW Government

    A substitute decision-maker can resign by giving written notice using this form to the person who appointed them. This form can only be used if the appointor still has the capacity to make personal decisions. Otherwise, the substitute decision-maker can only resign with approval from the NSW Civil & Administrative Tribunal.

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    Revocation of Appointment of Enduring Guardian (NSW)

    NSW Government

    View this form to revoke your appointment of an Enduring Guardian in New South Wales.

  • Website

    SLHD My Wishes (NSW)

    Sydney Local Health District

    Fact sheets and translations, booklets, templates and other advance care planning resources from Sydney Local Health District.

  • Form

    Statement of Values and Wishes (South Western Sydney, NSW)

    NSW Government

    View the advance care plan form to be completed by a person in South Western Sydney, NSW. It can be used as a template for anyone writing an advance care plan.

In the Northern Territory, an advance care plan is referred to as an Advance Personal Plan. The Northern Territory has one component to make an advance care plan:

Advance Personal Plan

In the Northern Territory, a person 18 years or over must complete the Advance Personal Plan form to make a legally-binding advance care plan. It can include decisions about future healthcare, statements about their views, wishes and beliefs, and appoint one or more persons as a substitute decision-maker. It may optionally be registered with the Public Trustee using the Application to Register an Advance Personal Plan form. If you use this form to appoint a substitute decision-maker as well, you must then register that section of the form with the Land Titles Office.

  • Website

    Advance care planning in the Northern Territory

    Northern Territory Government

    Learn more about advance care planning in the Northern Territory through the Northern Territory Government website.

  • Form

    Advance Personal Plan (NT)

    Northern Territory Government

    Advance care plan form to be completed by a person in the Northern Territory. A substitute decision-maker can also be appointed by using this form.

  • Form

    Application to Register an Advance Personal Plan (NT)

    Northern Territory Government

    View the form to register an advance care plan with the Public Trustee of the Northern Territory.

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    Application to Search or Obtain Information from the Advance Personal Plan Register (NT)

    Northern Territory Government

    Use this form as a spouse, de facto partner, child, or medical practitioner of a person who has made an Advance Personal Plan in the Northern Territory to apply to be provided with information concerning their advanced care plan.

In Queensland, the components of an advance care plan are:

Advance Health Directive

This legal document records a person's instructions for future health care. You can print a PDF copy of the form, fill out the form online and print a finished version or purchase a form from a newsagency or other private business in Queensland (such as a bookshop or stationer). This is supported under the Powers of Attorney Act 1998. 

Enduring Power of Attorney

In Queensland, a person can legally appoint one or more substitute decision-makers. To appoint one decision-maker, a person should use the Short Form. To appoint more than one decision-maker, or appoint a different decision-maker for personal versus financial matters, a person should use the Long Form.

This Powers of Attorney Act 1998 and Guardianship & Administration Act 2000 allow for others, including an Enduring Power of Attorney/agent, to consent to withdrawing or withholding life-sustaining treatment.
Statement of Choices

A value-based document allowing a person to record their personal values and preferences for health care. The Statement of Choices helps to guide family and healthcare professionals decide on medical care when a person is unable to make or communicate decisions. There is a form for those who have decision-making capacity (Form A), and those without decision-making capacity (Form B).

  • Website

    Advance care planning in Queensland

    Queensland Government

    Learn more about advance care planning in Queensland through the Queensland Government website.

  • Form

    Advance Health Directive form (QLD)

    Queensland Government

    Download the form for people living in Queensland, that states your wishes or directions regarding your future health care for various medical conditions. It comes into effect only if you are unable to make your own decisions.

  • Form

    Enduring Power of Attorney – Short Form (QLD)

    Queensland Government

    View the form to legally appoint one attorney for personal matters (including healthcare) and/or financial matters.

  • Form

    Enduring Power of Attorney – Long Form (QLD)

    Queensland Government

    View the form to legally appoint an attorney(s) for personal matters (including healthcare) and a different attorney(s) for financial matters.

  • Form

    Revocation of Enduring Power of Attorney (QLD)

    Queensland Governement

    Visit the Queensland Government site to access the form required if you wish to revoke (cancel) the appointment of a person or persons as your attorney/s (enduring power).

  • Form

    Statement of Choices (QLD)

    Queensland Government

    Search and download localised Statement of Choices forms based on your postcode. Forms preferences, values and goals for future health care.

South Australia has one component to make an advance care plan:

Advance Care Directive

In South Australia, a person 18 years or over must complete the Advance Care Directive form to make a legally-binding advance care plan. A person uses this form to appoint a substitute decision-maker as well. This is supported under the Advance Care Directives Act 2013.

You can print a PDF copy of the form or fill out the form online and print a finished version.

Note: The new Advance Care Directive replaces the Enduring Power of Guardianship, Medical Power of Attorney and Anticipatory Direction documents. If a person has completed one of these documents before 1 July 2014, they will continue to have legal effect.

  • Website

    Advance care planning in South Australia

    Government of South Australia

    Learn more about advance care planning in South Australia through the SA Health website.

  • Form

    Advance Care Directive (SA)

    Government of South Australia

    View the advance care plan form to be completed by a person in South Australia. A substitute decision-maker can also be appointed by using this form.

  • Form

    Advance Care Directive Forms and DIY Kit (SA)

    Government of South Australia

    Complete your Advance Care Directive Form using an online interactive form or a do-it-yourself kit, which provide a step-by-step guide for making an advance care plan in South Australia, information for witnesses, substitute decision-makers and interpreters, and tear out forms.

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    Advance Care Direct wallet card (SA)

    Government of South Australia

    View the wallet-sized form with the details of a substitute decision-maker.

In Tasmania, the components of an advance care plan are:

Advance Care Directive

Use the Advance Care Directive form to write down specific information relating to your wishes, values and any treatments you would not wish to receive to inform your doctor and substitute decision-maker.

Enduring Guardian

In Tasmania, a substitute decision-maker is referred to as an enduring guardian. A person can appoint enduring guardians under the Guardianship and Administration Act 1995 as substitute decision makers.

  • Website

    Advance care planning in Tasmania

    Tasmanian Government

    Learn more about advance care planning in Tasmania through the Department of Health and Human Services website.

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    Advance Care Directive for Care at the End of Life (TAS)

    Tasmanian Government

    View the advance care plan form for people living in Tasmania.

  • Form

    Large Print Advance Care Directive for Care at the End of Life (TAS)

    Tasmanian Government

    View the advance care plan form in large print for people living in Tasmania.

  • Form

    Instrument Appointing Enduring Guardian(s) (TAS)

    Tasmanian Government

    View the form to legally appoint a substitute decision-maker in Tasmania.

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    Application for Recognition of Interstate Appointment (TAS)

    Tasmanian Government

    View the form required to apply to register a substitute decision-maker or administrator made in another Australian state or territory in Tasmania.

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    Request for Emergency Order (TAS)

    Tasmanian Government

    View the form to legally appoint a substitute decision-maker in urgent situations,

Medical Treatment Planning and Decisions Act 2016

The Medical Treatment Planning and Decisions Act 2016 enshrines advance care directives in law. It goes into effect 12 March 2018.

The following forms will still be valid after 12 March 2018 if they have been completed prior to the Act going into effect. You will not be required to complete new forms. If you are completing forms after 12 March 2018, different forms will be required. These will be available closer to the date.

In Victoria, the components of an advance care plan are:

Advance Care Plan

The state of Victoria offers a template that a person may fill out or use as an example to write their own advance care directive. Write down specific information relating to your wishes, values and any treatments you would not wish to receive.

Enduring Power of Attorney (Medical Treatment)

In Victoria, a substitute decision-maker is known as a 'medical agent' and is appointed using a Medical Enduring Power of Attorney form.

Refusal of Treatment Certificate

A patient can write a 'refusal of treatment' certificate, but only for a current illness, which does not have to be terminal (Medical Treatment Act 1988). The form for this is the Refusal of Treatment Certificate Competent Person (VIC).

The legislation also allows the appointment of an agent/substitute decision maker who can refuse treatment. The form for this is the Refusal of Treatment Certificate Agent or Guardian of Incompetent Person (VIC).

  • Articles & Publications

    Summary of the Medical Treatment Planning and Decisions Act 2016 (VIC)

    State Government of Victoria

    A summary of the Medical Treatment Planning and Decisions Act 2016 for health practitioners.

  • Articles & Publications

    Guide to the Medical Treatment Planning and Decisions Act 2016 (VIC)

    State Government of Victoria

    A guide to understanding the Medical Treatment Planning and Decisions Act 2016 for health practitioners.

  • Articles & Publications

    Medical Treatment Planning and Decisions Act 2016 FAQ (VIC)

    State Government of Victoria

    Answers to common questions for health practitioners and individuals who are affected by or interested in the Act that comes into effect March 2018.

  • Website

    Advance care planning in Victoria

    State Government of Victoria

    Learn more about advance care planning in Victoria through the Department of Health and Human Services website.

  • Form

    Advance Care Plan - Form/Template (VIC)

    Victorian Government

    Find out more about the advance care plan form template for people living in Victoria, with a link to download the form.

  • Form

    Refusal of Treatment Certificate Competent Person (VIC)

    Office of the Public Advocate

    Visit the website to read more about the certificate required if a person who is able to make decisions is refusing treatment in Victoria, with a link to download the form

  • Form

    Refusal of Treatment Certificate Agent or Guardian of Incompetent Person (VIC)

    Office of the Public Advocate

    Read more about the certificate required when a substitute decision-maker refuses treatment on behalf of a person who is unable to make decisions in Victoria, with a link to download the form.

  • Form

    Appoint an Enduring Power of Attorney (Medical Treatment)

    Office of the Public Advocate

    Find the form and more information about the medical enduring power of attorney legal document, where an individual appoints another person with the power to make decisions about medical treatment on their behalf.

In Western Australia, the components of an advance care plan are:

Advance Health Directive

Legally record your decisions for future health care treatments and procedures in an Advance Health Directive.

The Guardianship and Administration Act 1990 was amended by the Acts Amendment (Consent to Medical Treatment) Act 2008 to include an Advance Health Directive to refuse treatment for a current condition or terminal illness.

Enduring Power of Guardianship

In Western Australia, a substitute decision-maker is referred to as an enduring guardian.

Advance Care Plan

A person can record additional personal wishes not covered in the Advance Care Directive or Enduring Power of Guardianship in a separate form called an Advance Care Plan.

  • Website

    Advance care planning in Western Australia

    Government of WA, Department of Health

    Learn more about advance care planning in Western Australia through the WA Department of Health website.

  • Form

    Advance Health Directive (WA)

    Government of Western Australia

    View the advance care plan form for people living in Western Australia, recording decisions for healthcare treatments and procedures.

  • Form

    Advance Health Directive Alert Card (WA)

    Government of WA, Department of Health

    View the Advance Health Directive form for WA.

  • Form

    Enduring Power of Guardianship (EPG) Information Kit and Form

    Government of Western Australia

    View the information and form to legally appoint a substitute decision-maker in Western Australia. The form is included towards the end of the information kit.

  • Form

    My Advance Care Plan (WA)

    Government of Western Australia

    Advance care plan form for people living in Western Australia, recording additional personal wishes not covered in other formal WA documents, such as the Advance Health Directive and Enduring Power of Guardianship.