| Section 1 |
| Written legal documents |
| Living will |
| Durable power of attorney |
| Organ donations |
| Wishes concerning specific medical procedures |
| Organ donation |
| Kidney dialysis |
| Cardiopulmonary resuscitation |
| Respirators |
| Artificial nutrition |
| Artificial hydration |
| General comments |
| Section 2 |
| Overall attitude toward health |
| Perception of the role of clinician and other health caregivers |
| Thoughts about independence and control |
| Personal relationships |
| Overall attitude toward life |
| Attitude toward illness, dying and death |
| Religious background and beliefs |
| Living environment |
| Attitude concerning finances |
| Wishes concerning funeral |
