Adios – End of Life Planner

👤 Personal Information

Basic details to identify you and your document

First Name

Middle Name

Last Name

Maiden Name (if applicable)

Date of Birth

Place of Birth

Home Address

Cell Phone

Work Phone

Email Address

Citizenship

🛈 Sensitive identification numbers (passport, SSN, driver's license) should only be written in your printed copy, not entered digitally. Your PDF will include blank fields for these.

Where are your ID documents stored?

Religious Affiliation

Current Employer / Occupation

Highest Education

👪 Family & Emergency Contacts

People who should be notified and trusted

Spouse / Partner Name & Phone

Children (names, ages, contacts)

Closest next of kin

Emergency Contact 1 — notify first

Emergency Contact 2

Emergency Contact 3

Parents (if living)

Siblings

Other important relatives

Close friends to notify

📜 Legal Documents & Executor

Your legal arrangements and trusted representatives

Do you have a Will?

Yes

No

In Progress

Where is your Will stored?

Executor / Personal Representative name & contact

Alternate Executor (if first unavailable)

Do you have a Power of Attorney?

Yes

No

POA Agent name & contact

Do you have a Healthcare Proxy / Medical POA?

Yes

No

Healthcare Agent name & contact

Do you have a Living Will / Advance Directive?

Yes

No

Do you have a Family Trust?

Yes

No

Where are all legal documents stored?

Lawyer / Notary name & contact

🏥 Medical Information

Health details for emergency and end-of-life care

Blood Type

Organ Donor?

Yes

No

Primary Doctor name, phone & hospital

Specialist doctors

Chronic illnesses / conditions

Allergies (medications, food, substances)

Current medications

Serious illness / surgery history

Where are vaccination records stored?

Health insurance provider & policy number

Dental insurance provider

Vision insurance provider

💜 End of Life Medical Wishes

Your preferences for medical care — for guidance only

I want to be pain-free at end of life

Yes

No

I prefer to die at home (if possible)

Yes

No

I want hospice / palliative care

Yes

No

CPR if my heart stops?

Yes

No (DNR)

Breathing machine / ventilator if needed?

Yes

No

Artificial feeding if I cannot eat?

Yes

No

Dialysis if needed?

Yes

No

Take all steps to keep me alive (aggressive treatment)?

Yes

Comfort only

Sedation if pain is uncontrollable (may shorten life)?

Yes

No

People authorized to make medical decisions for me

Additional medical wishes or notes

💰 Finances & Assets

Overview — sensitive details are blank in your PDF

🔒

We do not collect financial account details

For your protection, we do not collect or store account numbers, routing numbers, card numbers, PINs, or any financial credentials.

Your PDF will include blank printable pages for these sections — designed to be completed privately by hand and stored securely offline. Use the printable version to store this information securely.

🏦 Bank account details 💳 Credit card numbers & PINs 📈 Investment accounts 💰 Retirement accounts 📋 Debts & loans 🧾 Tax records

✏️ Fill these in by hand after printing. Keep in a locked safe accessible only to your executor.

List of financial institutions you use (names only)

Where are your financial documents stored?

Do you have outstanding debts or loans? (general note)

🛡️ Insurance Policies

Your insurance coverage overview

Life Insurance — Provider, Beneficiary, where policy is stored

Home / Renters Insurance — Provider & where policy is stored

Car Insurance — Provider & where policy is stored

Other insurance policies

Long-Term Care insurance?

Yes

No

🔐 Passwords & Digital Life

Access guidance — never enter passwords online

🛡️

We never collect passwords or login credentials

Do NOT write passwords directly in any digital tool. We do not and will never ask for passwords, usernames, PINs, security codes, or login information.

Use a secure password manager or offline storage. Your PDF will include blank tracker pages to be filled in privately by hand.

💻 Website & email passwords 📱 Social media logins 🏦 Online banking 🚪 Home security codes 🔑 Safe & lock codes ❓ Security Q&A

Fill these in by hand after printing. Store with your executor only. Never share digitally.

Which password manager do you use? (app name only)

Where are your password / access instructions stored?

Instructions for your executor to access accounts

₿ Crypto & Digital Assets

Access guidance — never store seed phrases digitally

⚠️

Never store your seed phrase digitally in unsecured environments

We never collect seed phrases, private keys, or crypto wallet credentials.

Your PDF will include a blank section for crypto access instructions — to be completed by hand and stored in a physically secure location (e.g. fireproof safe, safety deposit box).

⚠️ Anyone with your seed phrase has full access to your crypto. Treat it like physical cash.

Do you hold cryptocurrency or digital assets?

Yes

No

Where are your crypto access instructions stored? (location only)

Who should your executor contact for crypto access?

🏠 Property, Vehicles & Belongings

Physical assets and what should happen to them

Real estate / property owned (type & location)

Vehicles (make, model, year)

Valuable items (jewelry, art, collectibles)

Where are important documents stored?

Instructions for personal belongings

🐾 Pets & Animals

Care instructions for your animals

Do you have pets?

Yes

No

Pet names, types, ages

Who will care for them after you?

Veterinarian name & contact

Pet care instructions

⚰️ Funeral & Final Wishes

How you want to be honored

Burial or cremation?

Burial

Cremation

Other

Preferred funeral home (if any)

Ceremony location

Cemetery / final resting place

Music preferences

Speakers / readings

Pallbearers

Reception preferences

Religious / cultural traditions

Who should be invited

Special requests

📝 Letters & Obituary

Words you want to leave behind

Letter to your family

Message to your spouse / partner

Message to your children

Letter of gratitude

Life advice / lessons to pass on

Obituary information (key life events, achievements)

💼 Business & Professional

Professional obligations and continuity

Do you own a business?

Yes

No

Business name & type

Who manages the business after you?

Business partners

Key contracts (description & where stored)

Outstanding client obligations

🏡 Home & Household

Household information and subscriptions to handle

Primary home address

Other properties / addresses

Utility providers (electric, gas, water, internet)

Subscriptions to cancel (Netflix, apps, etc.)

Memberships or clubs to cancel

📞 Professional Contacts

Key advisors your family needs to reach

Accountant / Tax advisor

Financial advisor

Estate / probate attorney

Insurance agents

Employer / HR contact

Religious leader / Clergy

✨ Special Wishes & Legacy

What matters most and how you want to be remembered

Wishes for your spouse / partner

Wishes for your children

Wishes for close relatives

Charitable causes or donations

Sentimental items and who should receive them

How you want to be remembered

📋 Final Notes

Last details for your family

Unfinished business or pending matters

Money owed to you or by you (general notes)

Notes for your family

Notes about your pets

Anything else important to know

This planner was prepared by

Privacy Policy

1. No Data Collection

2. How It Works

3. Sensitive Information

4. Cookies & Analytics

5. GDPR / CCPA

6. Your Responsibility

7. Contact

Terms of Service

1. Nature of Service

2. Not a Legal Document

3. Not Medical Advice

4. No Data Collected

5. No Warranties

6. Limitation of Liability

7. User Responsibility

8. Contact