The Medical Treatment Planning and Decisions Act 2016 enshrines advance care directives in Victorian law and creates clear obligations for health practitioners caring for people who do not have decision-making capacity.

To give Victorians confidence that their decisions about medical treatment will be respected, the Department of Health and Human Services  has created the standard forms below, which allow Victorians to:

  • Make an advance care directive which can include an instructional directive (which will provide specific directives about treatment a person consents to or refuses) and/or a values directive (which will describe a person's views and values).
  • Appoint a medical treatment decision maker (who will make decisions on behalf of a person when they no longer have decision making capacity).
  • Appoint a support person (who will assist a person to make decisions for themselves, by collecting and interpreting information or assisting the person to communicate their decisions).

For further information on advance care planning, please visit the Better Health Channel.

Additional resources for health practitioners can be found elsewhere in health.vic's Advance Care Planning section.

Advance care directive

Advance care directive for adults: this document allows an adult to document their preferences for future medical treatment, should they lose decision-making capacity. A person can record general statements about their values and preferences to guide future medical treatment decisions, or record instructions consenting to or refusing specific types of treatment.

Instructions for completing the Advance care directive form: these instructions providing additional guidance and information to assist in completing the Advance care directive for adults form.

Advance care directive for adults for someone signing on your behalf: use this form if you need someone to fill in and sign an advance care dierective for you, at your direction. This document allows an adult to document their preferences for future medical treatment, should they lose decision-making capacity. A person can record general statements about their values and preferences to guide future medical treatment decisions, or record instructions consenting to or refusing specific types of treatment.

Revocation of an advance care directive form: use this form to revoke a previously completed advance care directive.

Medical treatment decision maker

Appointment of medical treatment decision maker form: this document allows you to formally appoint a medical treatment decision maker, who will have legal authority to make medical treatment decisions on your behalf, should you become unable to do so.

Checklist of steps for appointing your medical treatment decision maker: this checklist provides additional guidance and information to help you appoint your medical treatment decision maker.

Appointment of medical treatment decision maker form (long): use this document if you wish to formally appoint multiple medical treatment decision makers, who will have legal authority (in order of appointment based on availability at the time), to make medical treatment decisions on your behalf, should you become unable to do so.

Appointment of medical treatment decision maker for someone signing on your behalf: use this document if you need someone to fill in and sign an appointment of medical treatment decision maker form for you, at your direction. This document allows you to formally appoint a medical treatment decision maker, who will have legal authority to make medical treatment decisions on your behalf, should you become unable to do so.

Revocation of medical treatment decision maker form: use this form to revoke your appointment of a medical treatment decision maker.

Resignation of medical treatment decision maker form: use this form to resign from being a person's appointed medical treatment decision maker.

Support person

Appointment of support person form: this form allows you to appoint a support person to assist you to make, communicate and give effect to your medical treatment decisions.

Checklist of steps for appointing your support person (medical treatment): this checklist provides additional guidance and information to help you appoint your support person.

Appointment of support person for someone signing on your behalf: use this document if you need someone to fill in and sign an appointment of support person form for you, at your direction. This form allows you to appoint a support person to assist you to make, communicate and give effect to your medical treatment decisions.

Revocation of support person form: use this form to revoke your appointment of a support person (medical treatment).

Resignation of support person form: use this form to resign from being a person's appointed support person (medical treatment).