Record your wishes
End of life planning form
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Are you prepared? Your checklist
1
Personal Information
2
How ready are you?
Name
(Required)
First
Last
Email
(Required)
Do you have a will?
(Required)
Yes
No
If so, is it up to date and does it reflect your current wishes?
(Required)
Yes
No
N/A
Have you appointed an enduring guardian in the situation that you can no longer make decisions for yourself?
(Required)
Yes
No
Have you completed an advance care directive?
(Required)
Yes
No
Do you have a funeral plan / insurance?
(Required)
Yes
No
Do your important people know the right people to contact on your behalf and do they know where to find their contact details? Your solicitor, your accountant, your financial advisor, your specific friends / family / colleagues, who you’d like to be notified.
(Required)
Yes
No
Do your support people know where important documents and information are stored? Will, deeds, funeral planning, enduring guardianship, power of attorney, digital passwords, statement of wishes and preferences, birth, marriage / divorce certificates etc…?
(Required)
Yes
No
If you have people in your care, for example children or someone with a disability, is it documented and clear who will take on his role if you are incapacitated mentally or you have died?
(Required)
Yes
No
N/A
If you have specific wishes / preferences from a cultural, religious, spiritual or personal perspective that are important to you leading up to your death or just after death, have you advised your people about this?
(Required)
Yes
No
N/A
If you have specific wishes related to your funeral, living wake, celebration of life, disposal of your body, prefer to have nothing etc have you documented this and are your people aware of your wishes?
(Required)
Yes
No
N/A
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