COVID Advance Medical Directive

Use this card to advise medical professionals of your wishes should you need hospital care.

If you are concerned about the possibility of one day ending up in the hospital as a result of an emergency and being administered the jab without your permission, then print off and sign this COVID Advance Medical Directive and attach it to your medical card.

It clearly states your non-consent to ANY COVID-19 vaccination, testing, ventilators or Remdesivir as is your right, should you be hospitalized and unable to verbally communicate with the medical professionals. Also, if you need treatment for COVID-19, you choose to use effective alternatives such as antivirals, vitamins C & D3, quercetin, zinc, HCQ, ivermectin and inhalers.

Missing from this card is a stipulation about blood transfusions. Canadian blood is tainted by the Covid Jab. At the bottom of the Medical Directive, if you so choose, write down in red ink “No Blood Transfusions” in the event one is required. For surgeries, you can save up your own blood beforehand. In case you have an accident, find an un-jabbed friend who shares your blood type who would be willing to donate and add his/her contact info next to this card in your wallet.

The Directive has been designed in such a way that it covers your personal details on your Care Card. It should be taped to your card to keep it secure and also as further proof that it has been seen by the medical professionals, as they will have to remove it to get your Care Card number.

We request a minimum $5 donation per page (includes 4 cards). 


  • Print off the pdf
  • Cut out the COVID Advance Medical Directives following the outer dotted lines, then fold each one in half.
  • Fill in your name on the front and your full legal name, signature and date on the back.
  • Then tape each side of the completed Directive to your Care Card, leaving the top edge of the Care Card visible.
  • Finally, take a photo of the Advance Directive attached to your Care Card for future evidence of your wishes.

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Thank you and God Bless Canada!

The Team @

Disclaimer: Action4Canada accepts no responsibility or liability for any harms or losses that occur as a result of using this Advance Medical Directive.
If you do not agree to what is specified on the above card please do not sign or use it. It is not intended as medical advice and you should consult your personal healthcare professional before use.