Create Advance Healthcare Directive Switzerland

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First Name:

Last Name:

Date of birth:

Address:

First Name:

Last Name:

Date of birth:

Address:

Telephone:

Email:

Same as Representative

First Name:

Last Name:

Date of birth:

Address:

Telephone:

Email:

My life should be preserved if there is a realistic prospect of improvement

Pain and discomfort should be relieved as effectively as possible

I do not want life-prolonging measures if there is no realistic prospect of improvement

I wish to receive dignified care at the end of life

Additional Wishes:

Organ Donation

I consent to organ donation

I refuse organ donation

My representative should decide

I have created this advance healthcare directive while being capable of making decisions.

Place:

Date:

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Name

Phone Number

Swiss Advance Healthcare Directive

Download Your Swiss Advance Healthcare Directive

Fill in your details and create your Advance Healthcare Directive for Switzerland online in a few simple steps.

Fill and Download Document

Document Template PDF

Please Provide Few More Details

Swiss Advance Healthcare Directive

Download Your Swiss Advance Healthcare Directive

Fill in your details and create your Advance Healthcare Directive for Switzerland online in a few simple steps.

Fill and Download Document

Document Template PDF

Personal Information

Representative

Alternate Representative

Personal Wishes and Values

Additional wishes

Medical Measures

Organ Donation

Confirmation

Please Provide Few More Details