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End of Life Option Act

The End of Life Option Act allows an adult diagnosed with a terminal disease, who meets certain qualifications, to request the aid-in-dying drugs from their attending physician.  The Act requires physicians to submit specified forms and information to the California Department of Public Health (CDPH). CDPH will collect data from forms submitted by physicians.  Annual reports will be made pursuant to the Act and relevant privacy requirements.


The new End of Life Option Act (EOLA) form submission portal is now available online. This EOLA portal enables all of the required forms to be completed online, electronically signed and submitted directly to CDPH. However, the original fillable forms can still be submitted to CDPH by mail, secure fax or secure e-mail. The fillable forms are available on the CDPH website.


To access the EOLA portal and complete the EOLA forms online please follow the instructions below:

  1. Click on the "Open Now" image above
  2. Select "Create an Account"
  3. Select the tile labeled "Center for Health Statistics and Informatics"
  4. Select "Get Started"
  5. You may select the form that you want to complete by selecting "Apply".  The first form that is required to be entered into the EOLA Portal is the Attending Physician Checklist & Compliance Form.   

If you have any questions regarding the EOLA form submission portal you may contact the EOLA at [email protected]

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