Skip to Content
Skip to Site Navigation
COVID-19 resources • COVID-19 fund • Virtual visits
Complete the form below to request an appointment with an Honoring Choices Facilitator.
Connect with an information specialist
If this is a medical emergency please call 911 immediately. Please do not include personal medical information on this form.
We respect your privacy.
The information that you provide via this website will be strictly confidential and is intended only for the use of Goshen Health in providing care and services to you.
Receive the medical care you want and ensure your loved ones know your wishes.
In the appointment, we’ll help you:
Note, it is important to have a family member or close friend that will be involved with your health care decisions attend the appointment.
Written documents give clear instructions about the kind of care you want at the end of life. By writing down your wishes, you can help your loved ones and doctors understand and follow your choices. That’s important if you are unable to make decisions or communicate for yourself.