For Muslim families · California

Islamic Health Care Directive Worksheet

Choose the person who will speak for you if you cannot, and tell your doctors and family how your faith shapes your care. Fill in what you can, a little at a time. Your answers save on this device only, and you can export them to Word for your doctor, imam, and attorney.

Draft, still being reviewed.This tool has not yet been reviewed by an attorney and a scholar. Use it to prepare and think. Have an attorney and a scholar review your final documents before you rely on them.

A worksheet is not the legal form, and not a fatwa.It prepares you. Have a legally effective directive signed with the right witnesses or a notary, and have questions of religious rulings confirmed by a qualified scholar.

Keep it private.Your answers stay on this device. Don’t enter account numbers or passwords. On a shared computer, press Clear all when you finish.