Advance Health Care Directive - Life Care Planning (LCP)
Forms:
Advance Health Care Directive (English)
Advance Health Care Directive (Spanish)
Completed Form Checklist:
- Pages are complete and legible
- Name and medical record number is on each page
- Document is signed
- Either the Statement of Witnesses or the Notary sections are completed
How to Submit your form for Napa Solano (Northern California) members:
1. Drop off at your most convenient facility Health Education Department
- Fairfield: 1st floor near the main entrance, #120
- Napa: Claremont bldg., 1st floor between Pharmacy 1 and Medicine 3
- Vacaville: MOB A, 1st floor, A14
- Vallejo: MOB, 2nd floor, #204
2. Upload your completed document online
- Sign on to kp.org
- Click on “Medical Record”
- Select “Life care planning”
- Upload a scanned document as a single PDF file by clicking on “Add a document”
- After reviewed and approved your AHCD form will be added to your medical record.