Advance Directives Legal Forms: 50-State Survey

An important component of estate planning is drafting an advance directive, or setting forth your health care wishes in the event that you become ill, incapacitated, or otherwise unable to communicate your medical treatment preferences to a doctor. The rules for how to prepare advance directive documents such as living wills and health care powers of attorney vary depending on where you live, but in each state there are forms you can use to memorialize your instructions in a legally binding manner.

The kinds of documents that may comprise an advance directive usually include some version of a living will, or instructions related to the health care you wish to receive or not receive if you cannot express your preferences, and a health care power of attorney, which gives someone else the authority to make medical and end-of-life decisions on your behalf (this person may be referred to as your health care agent or surrogate). Some states include other optional forms, such as those related to organ donation or do not resuscitate (DNR) orders.

In most states, any competent person who is at least 18 years old can execute an advance directive, as can emancipated minors in many places. In each jurisdiction, there are formalities you must follow in order for your advance directive to be valid, such as signing and dating it in the presence of two witnesses and/or a notary. Every state also has rules related to what you can do if you change your mind about the contents of your living will, or if you wish to revoke the authority of your health care agent. Finally, some states maintain advance directive registries, which give health care providers and others a centralized database through which to locate a patient’s treatment preferences.

Click on the states below for an overview of some of the main rules and requirements governing advance directives and living wills in each jurisdiction, along with links to forms you can use as part of your advance planning process.

Alabama

• Who can set up an advance directive: Any competent person who is 19 or older.
• Form requirements: You and two witnesses who are 19 or older must sign your advance directive.
• Advance directive registry/portable medical orders: Alabama does not maintain an advance directive registry, but you can file your documents with the probate court in the county in which you reside.

Types of advance directives in Alabama include a living will, health care proxy, and/or power of attorney. These documents are not valid in Alabama if executed by a pregnant individual. You can revoke your advance directive at any time through measures such as destroying the document(s), executing or asking another person to execute a signed and dated revocation, or verbally stating your desire to revoke the advance health care directive before a witness who is 19 or older, and who must sign and date a statement attesting to the revocation; this document must also be given to your health care provider to be effective.

Alaska

• Who can set up an advance directive: Any competent person who is 18 or older or an emancipated minor.
• Form requirements: Your power of attorney must be in writing, list a date of execution, and be signed by you and either signed by two witnesses or acknowledged at a notary public.
• Advance directive registry: No.

Types of advance directives in Alaska include a living will and durable power of attorney for health care. Except in cases of mental illness, you can revoke any part of your advance directive (not including designating a new agent) in any way that expresses your intent to revoke. You can designate a new agent only by executing a signed document or personally telling your supervising health care provider. Your agent can withhold or withdraw life-sustaining treatment if you have a writing such as an advance directive clearly expressing a desire to withhold or withdraw such treatment, or in the absence of any document stating the contrary if such withholding or withdrawal would be in your best interest.

Arizona

• Who can set up an advance directive: Competent persons who are 18 or older.
• Form requirements: Your advance directive must be signed and dated before at least one adult witness, which can be a notary public.
• Advance directive registry: Yes.

Types of advance directives in Arizona include a living will, health care power of attorney, mental health care power of attorney and prehospital medical care directive (do not resuscitate or DNR order). You can revoke your advance directive (except for a mental health care power of attorney) in writing, by verbally informing your health care provider or agent of your intent to revoke, executing a new advance directive, or any other action that shows your intention to revoke your advance directive.

• Life Care Planning, Arizona Attorney General
• Advance Directive Registry, Arizona Secretary of State

Arkansas

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: Your advance directive must be signed by you (or another at your instruction), and witnessed by two other people.
• Advance directive registry: No.

Types of advance directives in Arkansas include a living will, also known as a declaration relating to use of life-sustaining treatment (“declaration”), and a durable power of attorney. A declaration will not be honored in Arkansas if it has been executed by a pregnant person, and there is a chance that the fetus could develop to the point where a live birth may occur with ongoing life-sustaining treatment. You can revoke your declaration in any manner and at any time, regardless of your mental or physical condition, and your revocation will take effect once you notify your health care provider. You can revoke your durable power of attorney by executing a new one, or otherwise indicating in writing that you want to revoke it.

California

• Who can set up an advance directive: Any competent person who is 18 or older or an emancipated minor.
• Form requirements: You must sign and date your advance directive documents (or instruct an adult to sign on your behalf if you are unable to) before two witnesses or a notary.
• Advance directive registry: Yes.

Types of advance directives in California include a living will and power of attorney for health care. In California, your health care agent does not have the ability to allow sterlization, abortion, convulsive therapy, psychosurgery, or to have you placed in a mental health care facility. Except for the portion relating to the appointment of your health care agent, you can revoke all or part of your advance directive at any time and in any manner that communicates your intent to revoke. To revoke the appointment of your agent, you must either execute a new document revoking the appointment, or inform your supervising health care provider of your intent to revoke. If you sign a new advance directive, it will revoke the old one to the extent that any conflict between the documents exists.

• Advance Health Care Directive Form, California Attorney General
• Advance Health Care Directive Registry, California Secretary of State

Colorado

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: You must sign your living will or declaration before two witnesses.
• Advance directive registry: No.

Types of advance directives in Colorado include a medical durable power of attorney and a living will, also known as a declaration. You have the option of filling out an organ donation form as well. A Colorado declaration will not be valid if executed by a person who is pregnant with a potentially viable fetus. You can revoke your declaration in writing, verbally, or by destroying the document. You must notify your doctor in order for a revocation of your declaration to be effective. Similarly, you must notify your health care agent that you have revoked their authority for the revocation to take effect.

• Advance Medical Directive Information (Forms), Colorado Bar Association
• CPR Directive Information for Colorado Citizens, Colorado Department of Public Health & Environment

Connecticut

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: You must sign your advance directive in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in Connecticut include a living will and an appointment of a health care representative. You can also choose to designate a conservator and/or fill out an organ donation form. You can revoke your living will at any time, regardless of your physical or mental state, and in any manner. To revoke the appointment of your health care representative, you must articulate the revocation in a writing that is executed in the presence of two witnesses. You need to notify your health care provider to make sure that your advance directive revocations take effect. Unless you specify otherwise, the appointment of your spouse as your health care agent will automatically be revoked if you divorce or become legally separated.

Delaware

• Who can set up an advance directive: Any competent person who is 18 or older or an emancipated minor.
• Form requirements: You must sign your advance health care directive (or instruct someone else to sign it for you in your presence) in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in Delaware include a power of attorney for health care and living will or instructions for health care. You can fill out an optional organ donation form as well. In Delaware, life-sustaining treatment will not be withheld or withdrawn from a pregnant patient if the fetus is likely to survive with ongoing treatment. You can wholly or partially revoke your advance health care directive through a signed document, executing a new advance directive, or in any other fashion that expresses your intent to revoke the document(s) in the presence of two witnesses, of whom one must be a health care provider. Unless you provide instructions to the contrary, your spouse’s designation as your health care agent will be automatically revoked if you end your marriage or become legally separated.

District of Columbia

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: You must sign your living will in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in the District of Columbia include a durable power of attorney for health care and a living will, also known as a declaration. You have the option of executing an organ donation form as well. Unless authorized by a court, your health care agent cannot authorize sterilization, abortion, psychosurgery, convulsive therapy, or behavior modification encompassing aversive stimuli. You can revoke your declaration at any time, regardless of your physical or mental condition, by destroying the document or instructing someone else to do so in your presence, executing or asking another person to execute a written revocation and giving it to your doctor, or verbally revoking your declaration before an adult witness who signs and dates a document attesting to the revocation, which must then be given to your doctor. You can revoke your durable power of attorney by executing a new power of attorney, notifying your doctor of the revocation, or informing your attorney in fact. If your spouse or domestic partner is acting as your attorney in fact, their authority will be automatically revoked in the event of divorce or dissolution unless you specify otherwise.

Florida

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: You must sign your advance directive (or direct someone else to sign on your behalf) in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in Florida include a living will (which encompasses your organ donation wishes) and designation of a health care surrogate. Unless you explicitly state otherwise, your health care surrogate cannot authorize electroshock therapy, sterilization, abortion, experimental treatments, psychosurgery, or voluntary admission to a facility for mental health treatment. You can revoke your advance directive at any time by destroying the document, executing a new advance directive, or executing a signed and dated writing or making a verbal statement communicating your desire to revoke; revocation is effective after it is communicated to your doctor, health care facility, or surrogate. Without specific instructions from you to the contrary, if your spouse is serving as your health care surrogate, their authority will be revoked in the event of marital dissolution. You can give your health care surrogate the authority to withdraw or withhold life-sustaining treatment from you, even if you are pregnant.

Georgia

• Who can set up an advance directive: Any competent person who is 18 or older or an emancipated minor.
• Form requirements: You must sign your advance directive (or instruct another person to sign it for you) in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in Georgia include a designation of a health care agent, a document containing your health care preferences, and a designation of a guardian should you need one in the future. If you are pregnant with a viable fetus, your treatment preferences will not be honored in Georgia. You can revoke your advance directive at any time, without regard to your physical or mental health status, through actions such as destroying the document(s), executing a writing revoking your advance directive or asking another person to do so on your behalf, verbally revoking your advance directive before an adult witness who must memorialize the revocation in writing within 30 days, or by completing a new advance directive, to the extent that the new directive conflicts with the prior one. If you revoke your advance directive verbally or in writing as described above while you are being treated in a health care facility, your doctor must be informed of the revocation in order for it to be valid. If your spouse is appointed as your health care agent, their authority will automatically be revoked if your marriage ends unless you specify otherwise. Similarly, unless you give instructions to the contrary, if you get married after executing your advance directive, your marriage will revoke the authority of your health care agent if that person is not your spouse.

Hawaii

• Who can set up an advance directive: Any competent person who is 18 or older or an emancipated minor.
• Form requirements: You must execute your durable power of attorney for health care in the presence of two witnesses or a notary.
• Advance directive registry: No.

Types of advance directives in Hawaii include a durable power of attorney for health care decisions and a living will. You also have the option of filling out forms related to organ donation and designating your primary physician. You can revoke your advance directive (except for the appointment of your health care agent) at any time and in any fashion that conveys your wish to revoke. If you execute a new advance directive, it will automatically revoke the old one to the extent that the two documents conflict. To revoke the authority of your health care agent, you must execute a signed writing or notify your doctor. Unless you specify otherwise, if your spouse is your health care agent, their authority will be revoked if your marriage ends or you become legally separated.

Idaho

• Who can set up an advance directive: Any competent person who is 18 or older or an emancipated minor.
• Form requirements: Your advance directive must be signed, but is not required to be signed in the presence of witnesses.
• Advance directive registry: Yes.

Types of advance directives in Idaho include a living will and durable power of attorney for health care. If you are pregnant, your living will won’t be honored in Idaho, though your health care agent can still make decisions for you if needed. You can revoke your advance directive at any time by destroying the document(s) or asking someone else to do so in your presence, signing a writing revoking the advance directive, verbally communicating your wish to revoke your advance directive, or taking any other action that communicates your intent to revoke. In Idaho, medical care providers also have the legal right to decline to provide any treatment that is inconsistent with their beliefs.

• Living Will and Durable Power of Attorney for Health Care, Idaho Secretary of State
• Health Care Directive Registry, Idaho Secretary of State

Illinois

• Who can set up an advance directive: Any competent person who is 18 or older or an emancipated minor.
• Form requirements: Your living will must be executed in the presence of two witnesses, and your health care power of attorney must be executed in the presence of one witness.
• Advance directive registry: No.

Types of advance directives in Illinois include a living will and power of attorney for health care. If you are pregnant, your advance directive will not be honored in Illinois if the fetus could develop to the point of live birth with continued application of life-sustaining treatment. You can revoke your advance directive at any time by destroying the document(s), executing a written statement revoking the document(s) or instructing someone else to do so on your behalf, communicating your intent, either verbally or otherwise, to revoke your advance directive before a witness who must then sign and date a document memorializing your revocation. You can also delete an electronic declaration in any manner that conveys your intent to revoke via a secure technology system that fulfills the requirements for electronic signatures. Your revocation will not take effect until it is communicated to your doctor.

Indiana

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: You must execute your declaration in the presence of two witnesses, and you must execute your health care power of attorney in the presence of one witness.
• Advance directive registry: No.

Types of advance directives in Indiana include a living will declaration, a life prolonging procedures declaration, and an appointment of health care representative and power of attorney. You also have the option of filling out an organ donation form. If you are pregnant, your wishes to have life-sustaining treatment withdrawn or withheld will not be honored in Indiana. You can revoke your health care declaration by executing a revocation in writing, verbally communicating your wish to revoke, or destroying the declaration or asking another to do so in your presence. A revocation of your declaration is only effective once it is communicated to your doctor. You can revoke your health care representative’s authority by informing them or your doctor of the revocation verbally or in writing.

Iowa

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: You must execute your advance directive in the presence of two witnesses or a notary.
• Advance directive registry: No.

Types of advance directives in Iowa include a durable power of attorney for health care and a living will, also known as a declaration. You have the option of filling out an organ donation form as well. You can revoke your advance directive at any time and in any fashion, without regard to your mental or physical state. Your revocation becomes effective when it is communicated to your doctor. If your spouse is your health care agent, their authority is revoked if your marriage ends.

Kansas

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: You must execute your advance directive in the presence of two witnesses or a notary.
• Advance directive registry: No.

Types of advance directives in Kansas include a durable power of attorney for health care decisions and a living will, also known as a declaration. You have the option of filling out organ donation and do not resuscitate (DNR) forms as well. Your declaration is not valid in Kansas if you are pregnant. You can revoke your declaration by destroying the document, writing and signing a revocation (or asking someone else to do it for you), or verbally communicating your intent to revoke in front of an adult witness, who must then memorialize your revocation in writing; a verbal revocation is only effective once it is communicated to your doctor. You can revoke your health care agent’s authority by informing them of the revocation verbally or in writing; the revocation becomes effective once it is communicated to your doctor.

Kentucky

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: You must execute your advance directive in the presence of two witnesses or a notary.
• Advance directive registry: Yes.

Advance directives in Kentucky can include living wills, which encompass instructions for designating a health care surrogate, refusing or requesting food, hydration, or life prolonging treatment, and organ donation. Living wills are not honored for pregnant individuals in Kentucky. You can revoke all or part of your advance directive at any time that you have competency to make your own decisions through a written revocation, a verbal revocation made in the presence of two adults (one of whom must be a medical care provider), or destroying the document(s) or asking someone to do it on your behalf.

• Living Wills in Kentucky, Office of the Kentucky Attorney General
• Kentucky Health Information Exchange Advance Directive Registry

Louisiana

• Who can set up an advance directive: Any competent person who is 18 or older.
• Form requirements: Your written advance directive must be executed in the presence of two witnesses.
• Advance directive registry: Yes.

Advance directives in Louisiana can include a living will, also known as a declaration, which can encompass a health care agent designation. You can revoke your declaration at any time and without regard to your mental state by destroying the document or asking someone else to destroy it in your presence, executing a written revocation, or verbally or nonverbally communicating your wishes to revoke it. Revocation will take effect once it is communicated to your doctor.

• Living Will Declaration Form, Louisiana Secretary of State
• End of Life Registry Programs, Louisiana Secretary of State

Maine

• Who can set up an advance directive: Any competent person who is 18 or older or an emancipated minor.
• Form requirements: You must execute your written advance directive (or ask someone to do it for you) in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in Maine include a power of attorney for health care and a living will. You have the option of filling out a form regarding organ donation as well. You can revoke any portion of your advance directive except for the appointment of your health care agent at any time and in any way that expresses your wish to revoke. You can revoke your health care agent’s authority in a signed writing or by personally informing your doctor of the revocation. If you create a new advance directive, it will revoke the prior one to the degree that the two directives conflict. Unless you instruct otherwise, if your spouse is your health care agent, their authority will be revoked if your marriage ends or you become legally separated.

Maryland

• Who can set up an advance directive: Anyone who is at least 18 years old or who is married or has a child.
• Form requirements: You must sign and date the document in the presence of two witnesses, who must also sign and date it.
• Advance directive registry: Yes (through private service).

Types of advance directives in Maryland include a living will, also known as treatment preferences, and a durable power of attorney for health care. The state also provides a supplementary form that allows you to arrange for organ donation or the final disposition of your remains. You can revoke your advance directive by executing a new directive, destroying or defacing the directive, issuing a signed and dated revocation (electronically or in writing), or telling your doctor that you are revoking the directive. If you choose to revoke the directive, you should inform your agent, your doctor, and anyone else who may have a copy of it. You can waive your right to revoke the directive or change your agent during a period when you are certified to be mentally incapable of making an informed decision.

• Advance Directives, Maryland Attorney General
• MyDirectives (private advance directive registry recognized by Maryland Health Care Commission)

Massachusetts

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign the document (or direct another person to sign it) in the presence of two witnesses, who must also sign it.
• Advance directive registry: No.

Advance directives in Massachusetts are limited to health care proxies. The state also provides an organ donation form. State law does not provide for living wills. To revoke your health care proxy, you can execute another health care proxy, tell your health care agent or your doctor (orally or in writing) that you are revoking it, or take some action that indicates a specific intent to revoke the health care proxy. For example, you could physically destroy the document. If you end your marriage, and your spouse is your health care agent, their authority is automatically revoked.

Michigan

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign the document in the presence of two witnesses, who must also sign it.
• Advance directive registry: Yes.

Advance directives in Michigan are limited to durable powers of attorney for health care, also known as patient advocate designations. The state also provides an organ donation form. State law does not provide for a living will, but you can include information that would be covered in a living will in the patient advocate designation. You can revoke your patient advocate designation at any time and in any way, as long as your intent to revoke it is clear. You should make sure to notify your patient advocate and health care provider. Revocation is automatic if a patient advocate resigns their duties, or if the patient advocate is your spouse, and a judge enters an order ending your marriage or issuing alimony. A patient advocate cannot withhold or withdraw treatment from a pregnant patient if this would result in the patient’s death.

• Advance Directives, State of Michigan
• Press Release (Michigan Peace of Mind Registry), State of Michigan, April 16, 2015

Minnesota

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You can sign the document in the presence of two witnesses, who must also sign it, or you can sign the document in the presence of a notary public.
• Advance directive registry: No.

Types of advance directives in Minnesota include a living will, also known as health care instructions, and a durable power of attorney for health care. You can revoke an advance directive by signing a written and dated statement to that effect, by destroying the directive or telling someone else to destroy it, by creating a new directive that is inconsistent with the previous directive, or by verbally stating your intent to revoke the directive in the presence of two witnesses (not necessarily in the presence of both witnesses at the same time). The appointment of a spouse or domestic partner as a health care agent is generally revoked automatically if the patient and their spouse or domestic partner start proceedings to end their marriage or domestic partnership.

Mississippi

• Who can set up an advance directive: Any competent person who is at least 18 years old or an emancipated minor.
• Form requirements: You must sign the document in the presence of two witnesses or in the presence of a notary public.
• Advance directive registry: No.

Types of advance directives in Mississippi include a living will, also known as individual instructions, and a durable power of attorney for health care. The state also provides a supplementary organ donation form. You can revoke the designation of your health care agent by signing a written revocation or by personally informing your health care provider. If your spouse is your health care agent, this designation will be automatically revoked if your marriage ends. Other than the designation of your health care agent, you can revoke an advance directive at any time and in any way, as long as your intent to revoke it is clear. For example, you can destroy the directive or sign a document stating that it is revoked. If you complete a new directive, the previous directive will be revoked only to the extent that it conflicts with the new directive.

Missouri

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: To complete a document that contains both a durable power of attorney for health care and a health care directive, you must sign and date it in the presence of two witnesses, and you must have your signature notarized. If you are completing only a durable power of attorney for health care, you only need to have your signature notarized. If you are completing only a health care directive, you only need to sign it in the presence of two witnesses.
• Advance directive registry: No (but the legislature has authorized its creation).

Types of advance directives in Missouri include a durable power of attorney for health care and a health care directive, which resembles a living will but has a broader scope. For example, it includes decisions related to organ donation. You can revoke an advance directive at any time and in any way that shows your intent to revoke it. This may involve destroying the document, signing a written revocation, or orally revoking the document. To revoke a durable power of attorney, you also must notify your agent or health care provider, or create a new durable power of attorney that appoints a new agent. If you named your spouse as your agent, filing a proceeding to end your marriage automatically results in the revocation of their authority. Any instructions to withhold or withdraw treatment will not be honored if the patient is pregnant. Special rules apply to the authority of a health care agent to withhold or withdraw artificial nutrition and hydration on a patient’s behalf.

Montana

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign the document in the presence of two witnesses, or direct someone else to sign it in the presence of two witnesses.
• Advance directive registry: Yes.

Types of advance directives in Montana include a durable power of attorney for health care and a living will, also known as a terminal conditions declaration. The state also provides a form for decisions regarding organ donation and the final disposition of remains, as well as a form on which an individual can describe a chronic illness or serious disability that should not be interpreted as a terminal condition. You can revoke an advance directive at any time and in any way, but you must notify your health care provider or have a witness to your revocation notify your health care provider. If you named your spouse as your representative in your durable power of attorney, their authority will be revoked automatically upon divorce or legal separation. Any instructions to withhold or withdraw life-sustaining treatment will not be honored if the patient is pregnant, as long as the fetus likely could survive to live birth if the patient receives life-sustaining treatment.

• Advance Directive, Montana Department of Justice
• End of Life Registry, Montana Department of Justice

Nebraska

• Who can set up an advance directive: Anyone who is at least 19 years old or who is or has been married.
• Form requirements: You can sign the document in the presence of two witnesses, or you can have your signature witnessed by a notary public who is not your attorney in fact or alternate attorney in fact.
• Advance directive registry: No.

Types of advance directives in Nebraska include a durable power of attorney for health care and a living will, also known as a declaration. The state also provides a supplementary organ donation form. You can revoke your advance directive at any time that you are competent and in any way that shows your intent to revoke it. The revocation will take effect once you notify your attending physician, health care provider, or attorney in fact. If you create a new power of attorney for health care, this will automatically replace any previous power of attorney. If you appointed your spouse as your attorney in fact, their authority likely will be automatically revoked upon a decree of divorce or separation. Instructions to withhold or withdraw life-sustaining treatment from a pregnant patient will not be honored if the fetus likely would survive to live birth if the patient receives life-sustaining treatment.

• Nebraska Power of Attorney for Health Care, Nebraska Department of Health and Human Services
• Nebraska Living Will Declaration, Nebraska Department of Health and Human Services

Nevada

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign the directive in the presence of two witnesses and use the required statutory language. If you are completing only a durable power of attorney, you can have your signature witnessed by a notary public instead, while using the required statutory language.
• Advance directive registry: Yes.

Types of advance directives in Nevada include a durable power of attorney for health care decisions and a living will, also known as a declaration. In some cases, a health care professional must complete a certification of competency as well. Nevada also provides separate sets of advance directives for adults with intellectual disabilities and adults with dementia. You can revoke a directive at any time and in any way that shows your intent to revoke it. Revocation of a durable power of attorney takes effect when you notify your agent or your health care provider. Revocation of a living will (declaration) takes effect when you notify your doctor. A durable power of attorney is automatically revoked if you create a new durable power of attorney. If your spouse is your agent, their authority will be automatically revoked if your marriage ends. Instructions to withhold or withdraw life-sustaining treatment from a pregnant patient will not be honored if the fetus likely would survive to live birth if the patient receives life-sustaining treatment. Moreover, a health care agent cannot agree on a patient’s behalf to abortion, sterilization, commitment to a mental health facility, or certain other forms of treatment. A patient can set an expiration date for a durable power of attorney if they choose.

• Advance Care Planning Forms, Nevada Center for Ethics and Health Policy
• Advance Directive Registry, Nevada Secretary of State

New Hampshire

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You can sign the document in the presence of two witnesses or in the presence of a notary public or a justice of the peace.
• Advance directive registry: No.

Types of advance directives in New Hampshire include a durable power of attorney for health care and a living will, also known as a declaration. The state also provides a supplementary organ donation form. You can revoke an advance directive by creating a new advance directive, by orally revoking the advance directive in the presence of two witnesses, or by sending a signed and dated revocation to your agent, health care provider, or residential care provider. You also can revoke an advance directive by destroying the document or telling someone else to destroy it in your presence. If you named your spouse as your agent, their authority will be automatically revoked if an action is filed for a divorce, legal separation, annulment, or protective order. Your agent cannot agree on your behalf to voluntary sterilization or voluntary admission to a state institution. Your agent generally cannot direct health care providers to withhold life-sustaining treatment if you are pregnant, with some exceptions.

New Jersey

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign and date the document (or direct someone else to sign and date it) in the presence of two witnesses, who must also sign it. Alternatively, you can sign and date the document (or direct someone else to sign and date it) in the presence of a notary public, an attorney at law, or someone else who has the authority to administer oaths.
• Advance directive registry: No (except for psychiatric advance directives).

Types of advance directives in New Jersey include a durable power of attorney for health care and a living will. These are also known as a proxy declaration and an instruction declaration, respectively. You can include instructions specific to your pregnancy if you choose. You can revoke a directive by executing another directive or by providing oral or written notice of the revocation to your health care representative, a health care provider, or a reliable witness. You also can revoke a directive through any other act that shows your intent to revoke it, such as destroying the document. If your spouse or domestic partner is your health care representative, their authority generally will be revoked automatically upon divorce, separation, or the termination of the domestic partnership.

New Mexico

• Who can set up an advance directive: Any competent person who is at least 18 years old or who is an emancipated minor between the ages of 16 and 18 who is or has been married, who is on active military duty, or who has been declared to be emancipated by court order.
• Form requirements: You must sign and date the document. New Mexico does not impose a witness requirement, although it is advisable to have witnesses in case the directive is later challenged.
• Advance directive registry: No.

Types of advance directives in New Mexico include a durable power of attorney for health care and a living will, also known as instructions for health care. The state also provides a form that allows you to designate a primary physician. To revoke the appointment of your health care agent, you must complete a signed revocation or personally tell your supervising health care provider. (A witness requirement applies if someone else must sign the revocation for you.) Other than the appointment of your health care agent, you can revoke an advance directive in any way that shows your intent to revoke it, which might involve destroying the document, signing a revocation, or notifying your health care agent or your doctor that you are revoking it. If you create a new advance directive, any previous directive will be revoked only to the extent that it conflicts with the new directive. If you designated your spouse as your health care agent, this designation will be automatically revoked upon divorce or annulment. Your health care agent cannot authorize your admission to a mental health facility, unless you expressly grant this authority.

New York

• Who can set up an advance directive: Any competent person who is at least 18 years old or who has been married or has a child.
• Form requirements: If you complete the health care proxy, you must sign and date it in the presence of two witnesses. If you complete only the living will, there is no witness requirement, but you may want to sign it in the presence of witnesses to reduce the risk of challenges later.
• Advance directive registry: No.

Types of advance directives in New York include a health care proxy and a living will. You can revoke an advance directive by providing oral or written notice to your health care agent or your health care provider. Alternatively, you can revoke a directive through any other action that shows your intent to revoke it. This might involve signing a written revocation, destroying the document, or creating a new advance directive.

• Health Care Proxy Form, New York Department of Health
• New York Living Will, Living Will Forms

North Carolina

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must complete and sign your health care power of attorney in the presence of two witnesses and a notary public. The witnesses must also sign the document, and the notary public must notarize it.
• Advance directive registry: Yes.

Types of advance directives in North Carolina include a durable power of attorney for health care and a living will, also known as an advance directive for a natural death. You can revoke your durable power of attorney by creating a new power of attorney, by signing and dating a written revocation, or by communicating your intent to revoke the power of attorney to your health care agent or health care provider. You must notify your health care agent and your doctor or psychologist for the revocation to take effect. If you named your spouse as your health care agent, their authority will be automatically revoked if your marriage ends. Meanwhile, you can revoke your living will in any way that shows your intent to revoke it, such as destroying the document, completing a written revocation, or notifying your doctor.

• Advance Health Care Directives, North Carolina Secretary of State
• Advance Health Care Directive Registry, North Carolina Secretary of State

North Dakota

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign the document (or direct someone to sign it for you) in the presence of two witnesses or a notary, who must also sign it.
• Advance directive registry: No.

Types of advance directives in North Dakota include a durable power of attorney for health care and a living will, also known as health care instructions. The durable power of attorney becomes effective only if the health care agent signs a form to accept their appointment. The state also provides a supplementary organ donation form. You can revoke an advance directive at any time by providing written or oral notice to your health care agent or your doctor, or by creating a new directive.

Ohio

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign the document (or direct someone to sign it for you) in the presence of two witnesses or a notary public.
• Advance directive registry: No.

Types of advance directives in Ohio include a durable power of attorney for health care and a living will, also known as a living will declaration. The state also provides a supplementary organ donation enrollment form. You can revoke an advance directive at any time and in any way, although you must notify your doctor for the revocation to take effect. Your health care agent generally cannot consent to the withholding or withdrawal of medical treatment if this would terminate your pregnancy, and instructions in a living will also generally will not be honored in this situation. Your agent cannot make decisions about life-sustaining treatment unless you are terminally ill or permanently unconscious. Any conflict between the living will and the durable power of attorney in this situation will be resolved in favor of the living will. Special rules apply to an agent’s authority to withhold or withdraw comfort care or artificial nutrition and hydration.

Oklahoma

• Who can set up an advance directive: Any person who is at least 18 years old.
• Form requirements: You must sign the document in the presence of two witnesses.
• Advance directive registry: Yes (through private services).

Types of advance directives in Oklahoma include a living will and a health care proxy. The state also provides an organ donation or anatomical gifts form. You can revoke an advance directive at any time and in any way, but the revocation will not take effect until you notify your health care provider, or until a witness to your revocation notifies them. A pregnant patient will receive life-sustaining treatment and artificial nutrition and hydration, regardless of instructions in their advance directive, unless they have specifically authorized these types of treatment to be withheld or withdrawn during their pregnancy.

• Advance Directives, Oklahoma State Department of Health
• MyDirectives (private advance directive registry recognized by Oklahoma Department of Health)
• US Advance Care Plan Registry (private advance directive registry recognized by Oklahoma Department of Health)

Oregon

• Who can set up an advance directive: Any competent person who is at least 18 years old, an emancipated minor, or married.
• Form requirements: You can sign the document in the presence of two witnesses, who must also sign it, or you can have it notarized by a notary public.
• Advance directive registry: No.

Types of advance directives in Oregon include a durable health care power of attorney and a living will. These are also known as an appointment of health care representative and health care instructions, respectively. The state also provides a supplementary organ donation form. You can revoke a directive at any time and in any way if you are capable of making medical decisions, and you can revoke it at any time and in any way that shows your intent to revoke it if the directive includes provisions related to withdrawal of life support or tube feeding. You can revoke a directive by creating a new directive in most cases, since the most recent directive overrides any previous directive or any previously expressed health care preferences that are inconsistent with it. If you appointed your spouse to serve as your health care representative, their authority generally will be automatically revoked if you file for divorce or annulment. A health care representative does not have the authority to make decisions regarding abortion, sterilization, or mental health treatment. They can make decisions regarding life-sustaining treatment only if the patient expressly grants this authority.

Pennsylvania

• Who can set up an advance directive: Any competent person who is at least 18 years old, a high school graduate, married, or an emancipated minor.
• Form requirements: You can sign and date the document in the presence of two witnesses, or you can direct someone else to sign and date it in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in Pennsylvania include a durable health care power of attorney and a living will. You can revoke an advance directive at any time and in any way, although the revocation does not take effect until you notify your health care provider, or until a witness notifies them. In most cases, the appointment of a spouse as a health care agent will be automatically revoked if either the patient or their spouse files for divorce. Instructions in the directive of a pregnant patient generally will not be honored, subject to certain exceptions.

Rhode Island

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign a durable power of attorney for health care in the presence of two witnesses or a notary public. You must sign a living will in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in Rhode Island include a durable power of attorney for health care and a living will, also known as a declaration. You can revoke an advance directive at any time and in any way. The revocation does not take effect until you notify your health care provider, or until a witness notifies them.

South Carolina

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign and date a durable health care power of attorney (or acknowledge your signature or direct someone to sign on your behalf) in the presence of two witnesses. You must sign a living will in the presence of two witnesses and have it notarized. The notary can count as one of the witnesses.
• Advance directive registry: No.

Types of advance directives in South Carolina include a durable health care power of attorney and a living will, also known as a declaration of a desire for a natural death. Separately from the agent appointed in the power of attorney, you can appoint an agent in a living will who can enforce or revoke its provisions; this agent will not have the authority to make any other medical decisions on your behalf. You can revoke a durable health care power of attorney by notifying your health care agent or your health care provider, or by creating a new health care power of attorney that states that the previous document is revoked. You can revoke a living will by creating a new living will, by signing and dating a revocation, by telling your doctor, or by destroying the document. Instructions in a living will to withhold or withdraw life-sustaining treatment, or instructions by your agent to that effect, will not be honored if you are pregnant.

• Health Care Power of Attorney, South Carolina Bar
• Living Will, South Carolina Bar

South Dakota

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign a living will (or have someone sign it for you) in the presence of two witnesses. No witness requirement applies to a durable health care power of attorney, but signing it in the presence of witnesses can be a useful precaution to prevent later challenges.
• Advance directive registry: No.

Types of advance directives in South Dakota include a durable power of attorney for health care and a living will, also known as a declaration. The state also provides a supplementary organ donation form. You can revoke a directive at any time and in any way that conveys your intent to revoke it. This might involve destroying the document, signing a written revocation, or orally stating your intent to revoke it in the presence of witnesses. The revocation of a living will takes effect once you notify your health care provider. You must notify your health care agent if you revoke a health care power of attorney, and you should record the revocation with the registry of deeds if you recorded the health care power of attorney there. You must specifically state that you want to have artificial nutrition and hydration withheld or withdrawn, or give your agent this authority, if you have this preference. If you are pregnant, any preferences for withholding or withdrawing life-sustaining treatment or artificial nutrition or hydration generally will not be honored. Your agent cannot withhold or withdraw comfort care.

• South Dakota Medical Power of Attorney Form, Living Will Forms
• South Dakota Living Will Declaration, Living Will Forms

Tennessee

• Who can set up an advance directive: Any competent person who is at least 18 years old or an emancipated minor.
• Form requirements: You can sign the document in the presence of two witnesses, or you can have it notarized.
• Advance directive registry: No.

Types of advance directives in Tennessee include a durable health care power of attorney and a living will. These documents are also known as an appointment of health care agent and an individual instruction, respectively. You can revoke the designation of your health care agent by signing a document to that effect or by personally notifying your supervising health care provider. If you designated your spouse as your health care agent, their authority generally will be automatically revoked upon a decree of divorce, separation, annulment, or dissolution of marriage. Other than the designation of your health care agent, you can revoke an advance directive whenever you have the capacity to revoke it and in any way that shows your intent. This might involve destroying the document or orally stating your intent. If you create a new advance directive, it will override any previous directive to the extent that they conflict.

Texas

• Who can set up an advance directive: Any competent person who is at least 18 years old. An emancipated minor may complete a durable health care power of attorney.
• Form requirements: You must sign the document (or direct someone else to sign it for you) in the presence of two witnesses, who must also sign it.
• Advance directive registry: No.

Types of advance directives in Texas include a durable health care power of attorney and a living will. These are also known as a medical power of attorney and a directive to physicians and family or surrogates, respectively. The state also provides a supplementary organ donation form. You can revoke a health care power of attorney by creating a new health care power of attorney or by notifying your health care agent, health care provider, or residential care provider. If your spouse is your agent, their authority will be automatically revoked in most cases upon divorce or annulment. You can revoke a living will by destroying it or having someone else destroy it, by signing and dating a written revocation, or by orally stating your intent to revoke it. However, you (or someone acting on your behalf) still must tell your health care provider that you have revoked it. A health care agent cannot consent on a patient’s behalf to abortion, psychosurgery, convulsive treatment, voluntary in-patient mental health services, or the withholding or withdrawal of comfort care. If you are pregnant, any instructions to withhold or withdraw life-sustaining treatment will not be honored.

Utah

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: While a directive may be oral or written, it is not legally binding unless it is signed in the presence of a witness, or unless you direct someone to sign it on your behalf in the presence of a witness.
• Advance directive registry: No.

Types of advance directives in Utah include a durable health care power of attorney and a living will. You can revoke an advance directive by destroying or obliterating it or having someone else destroy or obliterate it, by signing and dating a written revocation, by creating a new advance directive, or by orally stating your intent to revoke the directive in the presence of a witness. If your spouse is your health care agent, their authority generally will be automatically revoked upon a decree of divorce, legal separation, annulment, or dissolution of marriage. Your health care agent cannot arrange for your long-term custodial placement in a licensed health care facility without your permission, except in certain situations. If you are pregnant, any instructions to withhold or withdraw life-sustaining treatment will not be honored.

Vermont

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign and date the document in the presence of two witnesses. A patient who completes a directive in a hospital, nursing home, or residential care facility will need a signature from another person who has explained the directive to the patient and can verify that the patient understands its significance.
• Advance directive registry: Yes.

Types of advance directives in Vermont include a durable health care power of attorney and various provisions related to preferences regarding medical treatment, similar to a living will. The state also provides some supplemental forms, such as an organ and tissue donation form and a form that allows you to record your preferences for the final disposition of your remains. You can revoke a directive by destroying it, by creating a new directive, by signing a written revocation, or by personally telling your doctor and arranging for your doctor to note the revocation on your record. You also can revoke any part of a directive except for the designation of your health care agent through any action or statement that indicates your intent to revoke it. Your health care agent cannot arrange for your voluntary sterilization. Your agent cannot authorize or withhold health care over your objection if you do not have the capacity to make informed medical decisions, unless you expressly give your agent this authority in the directive, and certain other conditions apply.

• Advance Directive (Long Form), Vermont Department of Health
• Advance Directive (Short Form), Vermont Department of Health
• Registration Agreement and Policy, Vermont Advance Directive Registry

Virginia

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign the document in the presence of two witnesses.
• Advance directive registry: Yes.

Types of advance directives in Virginia include a durable health care power of attorney and a living will, also known as health care instructions. The state also provides a supplementary organ and tissue donation form. You can revoke a directive by destroying the document or directing another person to destroy it, by signing and dating a written revocation, or by orally stating your intent to revoke it. However, the revocation will not take effect until you notify your doctor. Your health care agent cannot consent on your behalf to abortion, non-therapeutic sterilization, or psychosurgery. Your agent cannot authorize or withhold health care over your objection if you do not have the capacity to make informed medical decisions, unless you expressly give your agent this authority in the directive, and certain other conditions apply.

• Advance Directive Forms, Virginia State Bar
• Virginia Advance Health Care Directives Registry, Connect Virginia

Washington

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: If you complete a living will, you must sign the document in the presence of two witnesses, or in the presence of a notary public or someone else who is similarly authorized to take acknowledgments. If you complete only a durable power of attorney for health care, there is no witness requirement, but it is still advisable to sign the document in the presence of witnesses to avoid future challenges to it.
• Advance directive registry: Yes (through private service).

Types of advance directives in Washington include a durable power of attorney and a living will, also known as a health care directive. The state also provides a supplementary organ and tissue donation form. You can revoke a directive by signing and dating a revocation, by destroying the document or having someone else destroy it in your presence, or by stating orally that you intend to revoke the directive. However, the revocation does not take effect until your doctor and your attorney-in-fact (if applicable) are notified. An advance directive will not have any effect while you are pregnant if the doctor is aware of your pregnancy.

• Advance Directives, Washington State Medical Association
• US Advance Care Plan Registry (private advance directive registry recognized by Washington State Department of Health)

West Virginia

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign the document (or direct someone to sign it for you) in the presence of two witnesses and before a notary public.
• Advance directive registry: Yes.

Types of advance directives in West Virginia include a durable health care power of attorney, also known as a medical power of attorney, and a living will. The state also provides a supplementary organ donation form. You can revoke an advance directive at any time by signing and dating a written revocation that you provide to your doctor, by destroying the directive or having someone destroy it for you, or by orally revoking the directive in the presence of a witness. The witness must sign and date a confirmation of your revocation. The revocation will take effect once you notify your health care representative and your doctor.

• Advance Directives, West Virginia Center for End-of-Life Care
• WV E-Directive Registry, West Virginia Center for End-of-Life Care

Wisconsin

• Who can set up an advance directive: Any competent person who is at least 18 years old.
• Form requirements: You must sign and date the document (or have someone sign and date it on your behalf) in the presence of two witnesses.
• Advance directive registry: No.

Types of advance directives in Wisconsin include a durable power of attorney for health care and a living will, also known as a declaration to physicians. The state also provides a supplementary organ donation form. You can revoke an advance directive by signing and dating a revocation statement, by destroying the document, by creating another directive, or by orally stating your intent to revoke the directive in the presence of two witnesses and then notifying your doctor. If you choose your spouse or domestic partner as your health care agent, their authority will be automatically revoked upon divorce, annulment, or termination of the domestic partnership. Your health care agent cannot consent on your behalf to various types of extreme interventions involving mental health. A living will is not effective during a pregnancy, and a durable health care power of attorney is effective during a pregnancy only if a patient expressly provides for its continued effect.

Wyoming

• Who can set up an advance directive: Any competent person who is at least 18 years old or an emancipated minor.
• Form requirements: You must sign and date the document (or direct someone to sign and date it on your behalf) in the presence of two witnesses or a notary public.
• Advance directive registry: No.

Types of advance directives in Wyoming include a durable power of attorney for health care and a living will, also known as instructions for health care. The state also provides a supplementary organ donation form and a form on which a patient can designate their primary physician. To revoke the designation of your health care agent, you generally must sign and date a revocation statement. If you choose your spouse as your agent, however, their authority will be automatically revoked upon a decree of divorce, legal separation, annulment, or dissolution of marriage. Other than the designation of your health care agent, you can revoke a directive at any time and in any way that shows your intent to revoke it, as long as you have the ability to make your own decisions. This means that you can revoke a directive orally, although ideally you should confirm the revocation in a signed document. If you create a new advance directive, it will override any previous directive to the extent of any conflict.

Last reviewed October 2022

Estate Planning Legal Center Contents

• Estate Planning Legal Center
• Asset Protection Under the Law
• Charitable Giving & Related Legal Issues
• Powers of Attorney Under the Law
• Guardianships of Minor, Elderly, and Incapacitated Persons Under the Law
• Social Security Disability Benefits Under the Law
• Social Security Benefits Under the Law
• Trusts & Their Legal Significance
• Probate Law
• Wills — Legal Requirements & Limitations
• Protecting Unmarried Partners Through Estate Planning & Related Legal Strategies
• How Second Marriages Can Legally Affect Estate Planning
• Retirement Plans and Pensions in Estate Planning & Legal Concerns
• Working With an Estate Planning Lawyer
• End of Life Decisions & Legal Implications
• Estate Planning Legal FAQs
• Estate Planning & Probate Legal Forms: 50-State Resources
  • Advance Directives Legal Forms: 50-State Survey
  • Wills Legal Forms: 50-State Survey
  • Guardianship Legal Forms: 50-State Survey
  • Name Change Legal Forms: 50-State Survey