Printable patient resources
Information authorised voluntary assisted dying practitioners need to provide to the person as they work their way through the voluntary assisted dying process.
The quick reference guidance for authorised practitioners (PDF 182 kB) gives an overview of the approved forms, patient information and medical record documentation at each stage in the process.
Jump to resources for:
Review and assessment
First request
Mandatory
- Approved first request information (PDF 1027 kB)—Queensland Health approved information that a medical practitioner is required under the Voluntary Assisted Dying Act 2021 to give to a person when they accept their first request to access voluntary assisted dying.
Optional
- Refusing the first request (PDF 288 kB)—information for a person whose first request for voluntary assisted dying is refused.
- Overview of the process (PDF 1268 kB)—high level overview of the process and steps at each stage.
- Quick reference guide (PDF 498 kB)—quick reference for people accessing voluntary assisted dying.
First assessment
Mandatory
- Copy of First Assessment Record Form—once completed in the QVAD Review Board IMS.
- Information as per the assessment checklist (PDF 251 kB).
Optional
- Information for people who are assessed as eligible for voluntary assisted dying (PDF 290 kB)—a high level summary of the information the coordinating doctor must tell the person verbally.
- Information for people who are assessed as ineligible for voluntary assisted dying (PDF 526 kB)—what to do next, support services available. Can be used if the person is assessed as ineligible at any stage during the process.
Consulting assessment
Mandatory
- Copy of Consulting Assessment Form—once completed in the QVAD Review Board IMS.
- Information as per the assessment checklist (PDF 251 kB).
Optional
- Information for people who are assessed as eligible or ineligible for voluntary assisted dying (PDF 290 kB)—high level summary of the information the coordinating doctor must tell the person verbally.
- Information for people who are assessed as ineligible for voluntary assisted dying (PDF 526 kB)—what to do next, support services available. Can be used if the person is assessed as ineligible at any stage during the process.
Second request
Mandatory
- Pre-filled Second Request Form—once completed in the QVAD Review Board IMS.
Optional
- Choosing witnesses (PDF 300 kB)—information to help the person choose and appoint their witnesses.
- Being a witness (PDF 305 kB)—information for people who are considering being the witness for the second request.
- Witness checklist (PDF 322 kB)—an optional checklist to help people complete their role as a witness.
Final request
No resources.
Final review
Mandatory
- Copy of Final Review Form—once completed in the QVAD Review Board IMS.
Administration of the voluntary assisted dying substance
Administration decision
Mandatory
- Information about substances for self-administration—this is provided to authorised voluntary assisted dying practitioners with the prescription and administration protocols. It is not publicly accessible.
- Information about substances for practitioner administration—this is provided to authorised voluntary assisted dying practitioners with the prescription and administration protocols. It is not publicly accessible.
Appoint a contact person
Mandatory
- Pre-filled Contact Person Appointment Form—once completed in the QVAD Review Board IMS.
Optional
- Choosing a contact person (PDF 315 kB)—information to help the person choose and appoint their contact person.
- Being a contact person (PDF 336 kB)—information for people who are considering being someone’s contact person.
- Contact person checklist (PDF 900 kB)—an optional checklist to help people complete their role as a contact person for both self-administration and practitioner administration.
Provided by the Voluntary Assisted Dying Review Board
- Information for the contact person—information provided to the contact person by the Review Board if a self-administration decision has been made. It is not publicly accessible.
Prescription
No resources.
Supply
Provided by QVAD-Pharmacy
- Information about voluntary assisted dying substances for self-administration—this is provided to the person by the pharmacist when the voluntary assisted dying substance is supplied. It includes how to store, prepare and administer the substance. It is not publicly accessible.
Administration of the substance
Self-administration
No resources.
Practitioner administration
Mandatory
Pre-filled Practitioner Administration Form—to be signed by the witness to practitioner administration.
Optional
- Choosing a witness for practitioner administration (PDF 294 kB)—information to help the person choose and appoint a witness for practitioner administration.
- Being a witness for practitioner administration (PDF 299 kB)—information for people acting as a witness for practitioner administration.
- Witness for practitioner administration checklist (PDF 309 kB)—optional checklist to help people complete their role as witness for practitioner administration.
After the person dies
Disposal
Self-administration
Provided by the Voluntary Assisted Dying Review Board
- Information for the contact person—information provided to the contact person by the Review Board if a self-administration decision has been made. It is not publicly accessible.
Practitioner administration
No resources.
Death notification
Optional
Role transfers
No resources.