About 5 Wishes®
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So many people today face important decisions about medical care for ill or aging family members and recognize that it is best to plan for their own future health care while they are still healthy.

The booklet, Five Wishes® is an easy-to-complete legal document that allows you to plan for your own health care and that of your family. This advance directive (AD) states personal wishes for treatment and care in the event one is injured, ill or can no longer speak for oneself.

If you purchase Five Wishes® through Kokua Mau, it automatically comes with lifetime electronic storage so that healthcare providers and hospitals can retrieve your advance directive anywhere in the U.S. (download writable form)

The Terri Schiavo case which involved a Florida woman who was in a persistent vegetative state for 14+ years, illustrates the unfortunate impact the lack of advance care planning can have on families and communities and the need for adults of all ages to document their wishes. (Terri was only 26 when she fell ill.)

THREE EASY STEPS will help you enhance your advance care planning process:
1. Complete the attached Five Wishes® booklet.
2. Sign the document in front of two witnesses.
3. Complete the Registration Agreement on the back of the booklet. Mail the signed Five Wishes® booklet to the address on the form for scanning into the MyHealthDirective.com database. Before you send your booklet make sure you have made copies for your doctors and loved ones. (To get an optimal
scanned document, please mail in the original Five Wishes booklet).

The Benefit? - Peace of mind for you and your loved ones knowing your wishes can be accessed in times of critical illness or medical emergency. A wallet card will be sent to you once your Five Wishes® have been scanned and securely stored.

The downloadable order from for Five Wishes® is also available in a writable format, which may be completed on your computer before printing.


 
Care Choices
Advance Directives


Kokua Mau Contact Information:
P.O. Box 62155
Honolulu, HI
96839

Tollfree:
(800) 474-2113
Phone:
(808) 585-9977
Fax:
(808) 988-3877

info@kokuamau.org