Future Planning New
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'My Wishes' Online Form

The Rowans Hospice volunteers have had their say. Gabi Froden, our artist, has worked her magic. And some poor bloke at the printers has stuck 32 000 cards onto 32 000 leaflets with 32 000 glue dots.
So now the Future Planning: My Wishes leaflet has arrived. However, if your writing is as illegible as mine (ex-GP and now Palliative Medicine Consultant) then you may want to use the Word Processor version of the form below to record your wishes.
We planned to use an online form, however to ensure the security of your data, even if only recording your data on screen long enough for you to print it out, we would have had to start adding significant security and cost to the running of the website. Hence, we have added a word document that you can download, fill in on your computer, tablet or phone.
Then sign it electronically by emailing directly to your GP. Or alternatively, print this out, sign and, post or hand it into your General Practice Reception.

Download your 'My Wishes' Form

Download Here
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Go to two Examples of completed forms
Return to top of page
  • HOME
  • Patients
    • What is Future Planning?
    • My Wishes
    • Dodgy Handwriting
    • Two Examples
    • Next Steps
  • Clinical Staff
    • Future Planning Introduction
    • General Practitioners >
      • Administration Support
      • Resources >
        • EMIS Template
        • SystmONE Template
    • Community Teams >
      • Using SystmONE for FP
      • SystmONE access to Summary Care Records
      • RiO access to Summary Care Records
    • Ambulance Services
    • Resources >
      • How to order My Wishes Leaflets
      • Future Planning Posters
      • Clinical Resources >
        • GSF Resources
        • End of Life Meds >
          • Wessex Green Book
          • End of Life Meds Worksheet
        • ACP info 4 clinicians
        • TEP_examples
        • DNACPR info 4 clinicians
  • FP Contacts
    • Contact us
    • Newsletter
  • Community