Additional Languages

The Massachusetts Health Care Proxy is available in English and 15 additional languages, including American Sign Language (video below).  As published for more than 25 years by nonprofit Massachusetts Health Decisions, it is a 4-page document in all versions. It includes information about the document itself, the Massachusetts Health Care Proxy Law and how it works, instructions on how to complete the form, and the form itself. This is why the document is subtitled: “Information, Instructions, and Form.”

Below are various versions of the Information and Instructions pages ONLY. The PDF documents below DO NOT INCLUDE THE FORM. You or a family member can download the information below to learn about the Health Care Proxy. But we encourage you to sign an English version.  The information, instructions, and form are exactly the same in every language.  For example, you can follow the instructions in the Spanish version to fill out the form in any other language version.  Get a free copy of the Massachusetts Health Care Proxy for your personal use here.

If you or your organization needs multiple copies of any version of the complete Massachusetts Health Care Proxy–in any language–you can order forms here.  Or download a copy of our Forms and Publications pricelist.  You can also read about purchasing a license so your organization can reproduce any version of the Massachusetts Health Care Proxy on your server. All Massachusetts forms and materials, in all languages, are protected by federal copyright laws and may not be reproduced or copied in quantity without our written permission, typically by license.

Arabic – Information & Instructions

Armenian – Information & Instructions

Braille: Download our Forms and Publications pricelist.

Chinese – Information & Instructions

French – Information & Instructions

Greek – Information & Instructions

Haitian – Information & Instructions

Italian – Information & Instructions

Khmer – Information & Instructions

Korean – Information & Instructions

Polish – Information & Instructions

Portuguese – Information & Instructions

Perguntas mais frequentes para o público – português

Russian – Information & Instructions

Spanish – Information & Instructions

Preguntas y Respuestas para el publico – Español

Vietnamese – Information & Instructions

American Sign Language

The video at the bottom of the page has 8 main sections. From the list below, you can click on the section you want to watch, and you will automatically jump to that part.  It is OK if you do not select anything from the menu.  The video will run continuously by itself.  The video has captions, and also voice narration.  This could be helpful if a hearing person wants to watch the video with you.

Start

Welcome

Video Operation & Sections

Section #1 What is a Health Care Proxy? Why is it important to you?

Section #2 Who can be my Agent?

Section #3 What can my Agent do?

Section #4 How will my Agent make decisions?

Section #5 When will my Agent make decisions?

Section #6 How do I fill out the form?

Subsection #6.1 Choosing an Agent

Subsection #6.2 Giving authority to your Agent

Subsection #6.3 Signing the Proxy

Subsection #6.4 Witnesses

Subsection #6.5 OPTIONAL

Section #7 Who should have the original and copies?

Section #8 How can I revoke or cancel the document?

This 28-minute video is a translation into American Sign Language of the “Massachusetts Health Care Proxy: Information, Instruction, and Form,” as published since 1991 by nonprofit Massachusetts Health Decisions (MHD). Visit MHD’s website for more information about the Health Care Proxy, as well as MHD’s grant-making program: “Health Decisions Resources.” Go to: www.masshealthdecisions.org