Your Values and Priorities

☐ What matters most to me when it comes to my health?

☐ What does “quality of life” mean to me?

☐ Do I value independence, comfort, longevity, or clarity — or a balance of these?

☐ How do my cultural, spiritual, or personal beliefs shape my healthcare decisions?

Your Medical Care Preferences

☐ Do I want aggressive treatments, or do I prefer comfort-based care if I’m seriously ill?

☐ How do I feel about hospitalization, surgery, or long-term medications?

☐ Are there specific treatments I would want—or want to avoid?

☐ How much do I want to know about my condition or prognosis?

Communication and Decision-Making

☐ Do I want to be fully involved in every decision, or do I prefer to trust my care team?

☐ Who do I trust to speak for me if I can’t speak for myself?

☐ Have I had conversations with my loved ones about my wishes?

☐ Do I feel heard and respected by my current providers?

Your Advocacy and Support

☐ Do I feel confident asking questions and advocating for myself?

☐ Do I know how to access a patient advocate, social worker, or care coordinator?

☐ Would I benefit from a second opinion or additional support navigating care?

Your Planning Documents

☐ Have I completed an advance directive or living will?

☐ Do I have a healthcare proxy or durable power of attorney for healthcare?

☐ Are these documents shared with my loved ones and care team?

☐ Have I reviewed or updated them in the past year?

Your Overall Well-Being

☐ How is my mental and emotional health being addressed?

☐ Do I feel safe, seen, and cared for in my healthcare settings?

☐ What would help me feel more empowered in my health journey?

☐ Am I making space for rest, reflection, and healing—on my own terms?

Final Thought:

Your healthcare should reflect your values—not just your diagnoses.
The more you understand what matters to you, the more confidently you can shape your care.