Alternatives to the Public Advocate ACD Form in South Australia

The Public Advocate Form Is the Starting Point, Not the Whole Process

If you're looking for an alternative to the South Australian Office of the Public Advocate's ACD form, it helps to understand what that form actually is — and what it isn't. The Public Advocate provides the official statutory ACD form and an information sheet explaining the general purpose of the document. It's the correct template. Every legally valid ACD in South Australia ultimately uses this form or its SA Health equivalent.

What the Public Advocate doesn't provide is the procedural layer: how to write treatment refusals that clinicians must follow, how to coordinate SDM appointments in the legally correct signing order, how to verify your witness isn't disqualified, or how the ACD interacts with your EPA and will. The "alternatives" aren't different forms — they're different levels of guidance and support wrapped around the same statutory document.

Your Four Options Compared

Option 1: The Public Advocate / SA Health Form (Free)

This is the baseline. You download the form, read the information sheet, fill it in, find an authorised witness, and execute. If you've completed an ACD before or you're familiar with the Act's requirements, this works. The gap is entirely procedural — the form doesn't tell you how to write binding refusals (as opposed to advisory value statements), doesn't walk you through the SDM acceptance-before-signing sequence, and doesn't help you verify your witness isn't disqualified.

When it works well: You have a single SDM who lives locally, you're confident in your drafting, and your witness is a JP or solicitor you've already confirmed has no conflicts.

When it falls short: You're coordinating multiple SDMs, you need to draft precise treatment refusals for specific medical interventions, or your witness pool is limited by the Act's conflict-of-interest rules.

Option 2: Hospital Advance Care Planning Programs (Free)

Several SA hospitals and aged care networks run structured Advance Care Planning (ACP) programs. These typically involve a trained nurse or social worker facilitating a conversation with you about your values, goals, and treatment preferences. The facilitator helps you think through your choices, and sometimes an eligible clinical staff member witnesses the final document.

SA Health's ACP framework uses a structured conversation model — the 7-Step Pathway — that's designed to translate your preferences into clinical language. Some programs are available through GP practices, others through hospital outpatient services or residential aged care facilities.

When it works well: You're already a hospital patient or aged care resident and the program is available at your facility. The nurse-facilitated conversation can surface clinical nuances you wouldn't think of on your own. The facility may be able to help arrange an eligible witness.

When it falls short: Availability is limited — not all hospitals run these programs, waitlists can stretch months, and regional facilities may not offer them at all. The programs focus on the clinical conversation, not the legal execution: they may help you decide what you want, but they don't always cover the SDM coordination logistics, witness verification, or EPA integration. You still need to manage the procedural side yourself.

Option 3: Private Adelaide Estate-Planning Solicitor ($495–$1,430)

A solicitor drafts your ACD as part of a complete advance care document package — typically ACD, EPA under the Powers of Attorney and Agency Act 1984, and a will. The solicitor interviews you about your medical preferences and family circumstances, drafts the provisions in legally precise language, arranges the witnessing, and may provide secure storage for the original.

Solicitors also handle the one thing no kit or free form can: a professional capacity assessment. If there's any question about whether you (or your parent) have the decision-making capacity required to execute a valid ACD, a solicitor can arrange a formal assessment and certify the process.

When it works well: Your estate is complex, there's a history of family disputes, you need integrated ACD/EPA/will drafting, or there's a genuine question about capacity.

When it falls short: The cost is significant — $495 with a senior discount at the lower end, $1,430 or more for individuals. Turnaround is 3–6 weeks including appointments, drafts, and revisions. For families with straightforward needs, the solicitor's expertise in bespoke drafting and dispute-proofing exceeds what's required.

Option 4: A Structured Advance Directive Kit

A kit provides the procedural guidance layer that the free form omits, without the cost or timeline of a solicitor. The South Australia Advance Directive & Living Will Kit includes a 17-chapter guide covering the full Advance Care Directives Act 2013 (including the 2024 amendments), plus fillable worksheets for each stage of the process:

• A Treatment Decision Worksheet with pre-drafted refusal wording for CPR, ventilation, nutrition, dialysis, and related interventions — wording designed to qualify as binding refusals, not advisory value statements
• An SDM Appointment Worksheet for sequential ordering, limits, and acceptance tracking
• A Signing and Witnessing Checklist with the room-ready procedure
• A Conflict-of-Interest Witness Verification Checklist
• An EPA Coordination Worksheet cross-checking coverage gaps
• A Document Distribution Log covering My Health Record upload, certified copies, GP, hospital, and SDM distribution

When it works well: You're completing the ACD yourself (or coordinating a parent's ACD), you want procedural certainty without legal fees, and your family situation is straightforward enough that bespoke legal drafting isn't necessary.

When it falls short: You need a professional capacity assessment, you expect the ACD to be challenged, or you need a solicitor to integrate the ACD with a complex estate plan.

Who This Is For

• People who've looked at the Public Advocate's ACD form and found it too bare — blank fields with no guidance on what language to use or what mistakes to avoid
• Families coordinating a parent's ACD who need the SDM sequencing and witness verification procedures the free form doesn't cover
• Regional and remote South Australians who can't easily access hospital ACP programs or Adelaide solicitors
• Anyone who's read about the cost of a solicitor and decided it exceeds what they need for a straightforward advance directive

Who This Is NOT For

• People who need a formal capacity assessment — only a qualified medical practitioner or a solicitor-arranged assessment provides this
• Families in active dispute about a parent's care or estate — a solicitor adds evidentiary weight and dispute-proofing that a kit or free form can't
• Anyone who's already comfortable with the free form and confident in their drafting — if the Public Advocate's resources are sufficient for your situation, there's no reason to pay for additional guidance

Frequently Asked Questions

Is there an online alternative to the paper ACD form in SA?

The SA Health ACD form is available as a downloadable fillable PDF and can be completed by hand or electronically. The appointer's signing and witnessing must still happen in person, in the physical presence of the witness; digital copies can be uploaded to My Health Record after execution.

Can I use an interstate advance directive form in South Australia?

South Australia recognizes interstate directives provided their instructions comply with local law. If you live in SA, use the SA form — it makes local compliance straightforward.

What if the Public Advocate form changes after I've completed my ACD?

Form updates don't invalidate existing ACDs. Your directive remains valid as long as it was executed correctly under the version of the Act that applied at the time you signed it. If the Act itself is amended in a way that affects your provisions (as happened with the 2024 suicide and self-harm override), you may want to review your ACD to confirm it still operates as intended under current law.

Do I need to renew my advance care directive?

No. ACDs in South Australia don't expire. But it's good practice to review your directive every 2 years or after a significant life change (new diagnosis, marriage, divorce, death of a named SDM, relocation). If you want to change anything, you complete a new ACD that automatically revokes the old one.

Can my GP help me choose between these options?

Your GP can help with the clinical content — what treatments are available for your conditions, what outcomes to expect, and how to think about your preferences. They generally can't advise on the legal execution requirements or help you choose between a solicitor, a kit, and the free form. That's a procedural decision, not a medical one.

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