This is a statutory form that is provided for in the California Probate Code. It is a multi part document that provides a variety of options for the user. Part 1 of this form is a power of attorney for health care. Part 1 lets you name another individual as agent to make health care decisions for you if you become incapable of making your own decisions or if you want someone else to make those decisions for you now even though you are still capable. Part 2 of this form lets you give specific instructions about any aspect of your health care, whether or not you appoint an agent. Part 3 of this form lets you express an intention to donate your bodily organs and tissues following your death. Part 4 of this form lets you designate a physician to have primary responsibility for your health care.