Green Sleeve Alberta: What It Is, What Goes Inside, and Where to Keep It

A legally perfect Personal Directive is useless if nobody can find it during a 911 call. Alberta Health Services solved this problem with something almost disarmingly simple: a green plastic pouch called the Green Sleeve. If you or a parent has done any advance care planning in Alberta, this pouch is where that planning either works in the real world — or doesn't.

What the Green Sleeve Is

The Green Sleeve is an official green vinyl pocket distributed by Alberta Health Services. It holds your advance care planning documents in one standardized place, in a standardized order, so that paramedics, ER staff, and care facility teams can find and act on your wishes in seconds.

It's free. You can order one online through the AHS advance care planning portal, or pick one up from a family physician, home care coordinator, or hospital. There's a limit of two per household when ordering online.

What Goes Inside — In Order

The contents aren't random. Each document plays a different role, and the order matters:

1. Goals of Care Designation (GCD) Order — first, facing outward. This is the single-page medical order written and signed by your physician or nurse practitioner after an advance care planning conversation. It carries a code (R1–R3, M1–M2, or C1–C2) that tells clinicians exactly what level of intervention you want. This is the document paramedics and ER teams act on.
2. Advance Care Planning Tracking Record. A running log of the conversations you've had with your healthcare team about your wishes.
3. A copy of your Personal Directive. Behind the GCD order. The Personal Directive names your Agent — the person legally authorized to make healthcare decisions if you can't — and records your detailed instructions.

Note the division of labour: the GCD order is a medical document signed by a clinician. The Personal Directive is a legal document signed by you. The Green Sleeve carries both, because in a crisis you need the legal authority (who decides) and the clinical instruction (what to do) side by side.

Where to Keep It

On or near the refrigerator. Not in a drawer, not in a safe, not in a filing cabinet upstairs.

Alberta EMS teams are systematically trained to check on or near the fridge for a Green Sleeve during home emergencies. A Green Sleeve in a bedroom nightstand might as well not exist. A bank safe deposit box is even worse — it can be frozen upon death and is obviously useless during a medical emergency at 2 a.m.

Two more storage rules that people routinely miss:

• The Green Sleeve travels with you. Bring it to every hospital visit, ER trip, surgical admission, and medical appointment. It acts as your medical passport between settings.
• Bring it home again. If you're discharged, the sleeve leaves with you. Don't let it disappear into a hospital chart.

What the Green Sleeve Is Not

A few clarifications that prevent common mistakes:

• It's not a legal document. Owning a Green Sleeve grants nobody any authority. The Personal Directive inside does that; the sleeve is just the delivery mechanism.
• It's not a DNR. There's no checkbox on the pouch itself. The GCD order inside carries the nuanced code — full resuscitation (R1) is just as valid a designation as comfort care (C2). The sleeve serves whatever your choice is.
• It's not a replacement for the OPGT registry. Alberta's Office of the Public Guardian and Trustee runs a free, optional registry where you can record your Agent's contact information. Registering means a hospital can find your Agent even if the sleeve is lost. The two systems complement each other.

Getting the Documents That Go Inside

The Green Sleeve is only as good as its contents. The complete setup looks like this:

1. Make your Personal Directive — name an Agent and alternates, record your instructions, sign in wet ink with one valid witness (who cannot be your Agent, your Agent's spouse or partner, or your own spouse or partner).
2. Have the goals-of-care conversation with your physician or nurse practitioner, who then writes and signs the GCD order reflecting your choices.
3. Assemble the sleeve — GCD order first, tracking record, then a copy of the Personal Directive.
4. Put it on the fridge and tell your Agent and family where it is.

If you're helping an aging parent, this is one of the highest-value afternoons you can spend: the conversation, the clinician visit, and the fridge magnet.

The Bottom Line

Alberta's Green Sleeve system is the bridge between a legal document sitting in a drawer and a medical team actually following your wishes. Order the sleeve, get the GCD conversation on the calendar, and put a copy of your Personal Directive behind it.

The Alberta Advance Directive & Living Will Kit includes a step-by-step Green Sleeve setup checklist, a plain-English decoder for the GCD codes, and the Personal Directive forms and witnessing instructions that complete the package.

See more Alberta guides →