For Patients
If you have read the information on accessing the End of Life Option Act and all of this seems overwhelming, know that you are not alone.
Many people find accessing the law difficult. That’s why we are here to help.
Collectively we at EOLCCA have had decades of experience in death and dying and have been involved with the End of Life Option Act since its inception here in California. We will help you and your family walk through the process from beginning to end. We can explain all legal end-of-life options available in California including the End of Life Option Act and also provide support and advocacy throughout the process. There are other options we can discuss with you also. We provide this service at no charge.
Please call us at 760-636-8009 or email info@endoflifechoicesca.org to speak with a volunteer.
Forms For Patients
Patient's Request for Aid-in-Dying Drug (pdf)
Click to download document.
Patient's Final Attestation Form
Click to download document
Interpreter's Declaration
Click to download document