Advance Health Care Directives

Be sure your healthcare wishes are honored


Plan ahead of a health crisis and put your wishes and decisions in writing to help aid family communication and decision-making as well as facilitate patient / provider communication.


An advance directive is a legal document that helps ensure that your healthcare wishes will be respected even if you are unable to communicate for yourself.


This document lets your family and doctors know:

  • The person you want to make healthcare decisions for you when you can’t make them
  • The kind of medical treatment you want or don’t want
  • How comfortable you want to be
  • How you want people to treat you
  • What you want your loved ones to know

To have your advance directive part of your medical record, you may submit your completed advance directive form, along with the registration form (English and Spanish) any time to any Cottage facility.


To make it easy for your healthcare providers to access your advance directive, Cottage Health System will convert your document to an electronic file and make it available to your healthcare provider through our secured electronic health record portal. This assures that if you are admitted to one of our facilities, your wishes are already on file at Cottage.

  • Download an Advance Directive form here 
  • Download a Cottage Health System Advance Directive Registration form (English and Spanish) here
  • Or call Medical Social Services at (805) 569-7495 to obtain the forms.

To have your advance directive added to the Cottage Health System electronic health record portal:

  • Bring the completed forms to Hospitality (front desk), Health Information Management, or admitting area at any of our facilities.
  • Or mail to:

    Health Information Management

    Advance Directives

    PO Box 689

    Santa Barbara  CA  93102-0689

  • Or e-mail to:

    Health Information Management

Call Health Information Management at (805) 569-7306 if you have questions.


It is a good idea to tell your family that you have an advance directive on file at the hospital, and let them know how they can access a copy in the event of an emergency.






Call Medical Social Services at (805) 569-7495 to obtain a copy of the Advance Directive and Advance Directive Registration forms, or download them from the links below.


Advance Directive Frequently Asked Questions


End of Life Care


MedlinePlus: Advance Directives


Advance Directive form (English and Spanish) [PDF]


Advance Directive Registration form [PDF]