Finalization Requirements for Health Care Directives

Your state may require the signatures of witnesses or a notary public-- or both.

After you complete your health care directive, you must follow your state’s rules about how to make it legally valid and binding. All states require you to sign your document, or have someone sign on your behalf. And depending on the state, you must also have your document witnessed and notarized – and in some states both.

Read on for details about these signing requirements and about what your state will require you to do.

Signing Your Documents

Every state requires that you sign your documents—or direct another person to sign them for you. But do not sign them immediately. You must sign your documents in the presence of witnesses or a notary public—sometimes both, depending on state law. That way, there is at least one other person who can attest that you were of sound mind and of legal age when you made the documents.

If you are helping someone else prepare health care documents and that person is too ill or weak to sign them, you or another person may sign the documents at his or her direction. The person making the document and the signer should appear together in front of the witnesses and/or notary public (see below), so that someone can observe the signing and confirm, if it is ever necessary, that it is what the document maker wanted and directed.

Witnessing and Notarization

In most states, witnesses must sign your documents. In some states, you may have your documents notarized instead of witnessed. In others, you will be required to have both witnesses and a notary sign your document. Also, a few states have different requirements for the document directing your health care and the document naming your agent. See below for links to your state’s rules.

Witnessing

Many states require that two witnesses see you sign your health care documents and that they verify in writing that you appeared to be of sound mind and signed the documents without anyone else influencing your decision. Each state also has rules about who may serve as your witnesses. In many states, for example, a spouse, another close relative or any person who would inherit property from you is not allowed to act as a witness for the document directing health care. And many states prohibit your attending physician from being a witness. The goal of these laws is to be sure your witnesses do not have a personal or professional interest in your health care and, therefore, a conflict of interest.

Notarization

A notary public is an individual who is authorized by the state to verify signatures on documents. If your state requires notarization, you shouldn’t have any trouble finding a notary. You can find listings online or in the yellow pages. Many hospitals also have notary publics on staff. Depending on your circumstances, you may take your document to the notary, or the notary may come to you. The notary will watch you sign the document and may then sign the notary language on the form or fill in a separate form and attach it to your document.

Be prepared to show the notary some identification and to pay a small fee for the services. If you are a patient in a hospital, the service may be free of charge.

Finalization Terms

When you read the requirements for witnesses in your state (see below), you may find some unfamiliar words. Here are brief definitions of some terms that commonly occur.

  • Beneficiary. Any person who is entitled to inherit property from a deceased person.
  • Beneficiary of a will. Any person or organization named in a will to receive property, either as a first choice or if the first choice as beneficiary does not survive the person making the will.
  • Claim against the estate. Any right that a person has to receive property from a person’s estate. This may arise under a will or living trust, from a contract or because of a legal liability that the deceased owes to the person.
  • Devisee. Any person who either is entitled to inherit property from a person under state law or who has been named to inherit property in a will or living trust.
  • Heir at law. Any person who qualifies to inherit property from a person under state law. Usually, heirs at law are spouses, children, parents, brothers and sisters. However, if none of these people exist, an heir at law might be a niece, a nephew or even a distant cousin.
  • Inherit by operation of law. When a person dies owning property that has not been left by a will or by some other legal device such as a living trust, the property will be distributed according to the laws of the state where the person died—that is, by operation of law. These laws—commonly referred to as the “laws of intestate succession”—usually give property first to a spouse and children and then to parents, brothers and sisters.
  • Presumptive heir. Someone who would inherit property under state law unless a child was later born to the current owner of the property the presumptive heir expects to receive.

Your State’s Rules

Here are the finalization rules for each state.

State

Document Name(s) & Signing Requirements

Alabama

Advance Directive for Health Care

Two witnesses are required. Neither of your witnesses may be:

  • under the age of 19
  • your health care proxy
  • the person who signed your advance directive for you, if you were unable to sign it yourself
  • related to you by blood, marriage or adoption
  • entitled to any portion of your estate by operation of law or under your will, or
  • directly financially responsible for your medical care.

If you grant your proxy the power to direct your burial or cremation, your advance directive must also be notarized.

Alaska

Advance Health Care Directive

If you grant your agent power to direct your burial or cremation, your document must be notarized. If you do not grant this power, you may choose to have your document signed by two witnesses or notarized.

If you choose to have the document witnessed, neither of your witnesses may be:

  • your health care agent
  • your health care provider
  • an employee of your health care provider, or
  • an employee of the health care institution or health care facility where you are receiving health care.

In addition, at least one of your witnesses must not be related to you by blood, marriage or adoption—and must not be entitled to any part of your estate under a will or codicil (amendment to a will).

Arizona

Living Will & Health Care Power of Attorney

Both documents must be signed by at least one witness or notarized.

If you choose to have the document witnessed, you may choose to have one or two witnesses. If you choose to have one witness, your witness may not be:

  • any person involved in providing your health care
  • related to you by blood, marriage or adoption, or
  • entitled to any part of your estate by operation of law or under your will.

If you have two witnesses, your witnesses do not need to meet the last two requirements on the list above.

If you choose to have your document notarized, the notary may not be:

  • your health care agent, or
  • any person involved in providing your health care.

Arkansas

Living Will

Must be signed by two witnesses or notarized. If you choose to have your document witnessed, your witnesses must be at least 18 years old. In addition, one of your witnesses may not be related to you by blood, marriage or adoption, or entitled to any part of your estate under your will or by operation of law.

Durable Power of Attorney for Health Care

If you grant your agent power to direct your burial or cremation, your document must be signed by two witnesses. If you do not grant this power, you may choose to have the document signed by two witnesses or notarized. If you choose to have your document witnessed, your witnesses must be at least 18 years old. In addition, one of your witnesses may not be related to you by blood, marriage or adoption, or entitled to any part of your estate under your will or by operation of law.

California

Advance Directive for Health Care

Must either be signed by two witnesses or notarized.

If you choose to have the document witnessed, neither of your witnesses may be:

  • your health care agent
  • your health care provider
  • an employee of your health care provider
  • the operator of a community care facility
  • an employee of a community care facility
  • the operator of a residential care facility for the elderly, or
  • an employee of a residential care facility for the elderly.

In addition, one of your witnesses must not be related to you by blood, marriage or adoption—and must not be entitled to any part of your estate by operation of law or under your will.

Finally, if you are in a skilled nursing facility, the document must also be witnessed by a patient advocate or ombudsman. (This requirement applies whether the document is witnessed or notarized.)

Colorado

Declaration as to Medical or Surgical Treatment Medical Durable Power of Attorney

Both documents must be signed by two witnesses and may also be notarized.

Neither of your witnesses may be:

  • a physician
  • an employee of your attending physician
  • an employee of a health care facility where you are a patient
  • a person with a claim against your estate, or
  • a person entitled to any part of your estate by operation of law or under your will.

In addition, if you are a patient or resident of a health care facility, the witnesses cannot be patients of that facility.

Connecticut

Health Care Instructions and Appointment of Health Care Agent and Attorney-in-Fact for Health Care Decisions

Must be signed by two witnesses.

Although the law does not restrict who can serve as a witness, we suggest that your witnesses be at least 18 years old and the person named to serve as your health care agent and your attorney-in-fact for health care decisions not act as a witness. You and your witnesses may also sign in front of a notary public, but you are not required to do so.

Document Concerning Withholding or Withdrawal of Life Support Systems

Must be signed by two witnesses. Although the law does not restrict who can serve as a witness, we suggest that your witnesses be at least 18 years old and the person named to serve as your health care agent and your attorney-in- fact for health care decisions not act as a witness.

Appointment of Health Care Agent and Attorney-in-Fact for Health Care Must be signed by two witnesses. Although the law does not restrict who can serve as a witness, we suggest that your witnesses be at least 18 years old and the person named to serve as your health care agent and your attorney-in- fact for health care decisions not act as a witness.

Delaware

Advance Health Care Directive

The document must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • related to you by blood, marriage or adoption
  • an owner, operator or employee of a residential long-term health care institution in which you are a resident
  • a person directly financially responsible for your medical care
  • a person with a claim against any portion of your estate, or
  • a person entitled to any portion of your estate by operation of law or under your will.

If you are a resident of a sanitarium, rest home, nursing home, boarding home or related institution, one of the witnesses must be, at the time you sign the Advance Health Care Directive, a patient advocate or ombudsman designated by the Division of Services for Aging and Adults with Physical Disabilities or the Public Guardian.

District of Columbia

Declaration

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • related to you by blood, marriage or domestic partnership
  • your attending physician
  • an employee of your attending physician
  • an employee of a health care facility where you are a patient
  • the person who signed your declaration for you, if you were unable to sign it yourself
  • a person entitled to any part of your estate by operation of law or under your will, or
  • a person directly financially responsible for your medical care.

If you are a patient in a skilled care facility, one witness must be a patient advocate or ombudsman.

Durable Power of Attorney for Health Care

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • your health care attorney-in-fact
  • your health care provider, or
  • an employee of your health care provider.

In addition, one of your witnesses must not be related to you by blood, marriage or adoption and must not be entitled to any part of your estate by operation of law or under your will.

Florida

Living Will

Must be signed by two witnesses, one of whom must not be your spouse or related to you by blood.

Designation of Health Care Surrogate

Must be signed by two witnesses, both of whom must be at least 18 years old. Neither witness may be your health care surrogate. In addition, one of your witnesses must not be your spouse or a blood relative.

Georgia

Advance Directive for Health Care

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • your health care agent
  • a person who is directly involved in your health care, or
  • a person who will knowingly inherit anything from you or knowingly gain a financial benefit from your death.

In addition, only one of your witnesses may be an employee, agent or medical staff member of the hospital, skilled nursing facility, hospice or other health care facility in which you are receiving health care. (This witness is still prohibited from being directly involved in your health care.)

Hawaii

Advance Health Care Directive

If you grant power to direct your burial or cremation, your document must be notarized. If you do not grant this power, you may choose to have your document signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be:

  • your health care agent
  • a health care provider, or
  • an employee of a health care provider facility.

In addition, at least one of your witnesses must not be related to you by blood, marriage or adoption—and must not be entitled to any part of your estate by operation of law or under your will.

Idaho

Living Will and Durable Power of Attorney for Health Care

Idaho law does not require that your documents be witnessed or notarized. However, witnesses are recommended to avoid concerns that the document was forged, that you were forced to sign it or that it does not represent your wishes. If you choose to have your documents witnessed, we suggest that your witnesses be at least 18 years old and that your health care agent not act as a witness.

Illinois

Declaration

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • the person who signed your declaration for you, if you were unable to sign it yourself
  • a person entitled to any part of your estate by operation of law or under your will, or
  • a person directly financially responsible for your medical care.

Durable Power of Attorney for Health Care

Must be signed by one witness. Your witness may not be:

  • under the age of 18
  • your attending physician, advanced practice nurse, physician assistant, dentist, podiatric physician, optometrist or psychologist
  • a relative of any of the health care professionals listed just above
  • an owner, operator or relative of an owner or operator of a health care facility in which you are a patient or resident (this includes directors or executive officers of an operator that is a corporate entity, but not other employees of the operator, such as non- owner chaplains, social workers or nurses)
  • a parent, sibling or descendant, or the spouse of a parent, sibling or descendant, of either you or your agent or alternate agent, regardless of whether the relationship is by blood, marriage or adoption, or
  • your agent or alternate agent for health care.

Indiana

Living Will Declaration

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • your parent, spouse or child
  • a person entitled to any part of your estate
  • a person directly financially responsible for your medical care, or
  • the person who signed your declaration for you, if you were unable to sign it yourself.

Durable Power of Attorney for Health Care and Appointment of Health Care Representative

Must be notarized.

Iowa

Declaration & Durable Power of Attorney for Health Care

Both documents must follow the same requirements: Must be signed by two witnesses or notarized.

If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18
  • your health care agent
  • your health care provider, or
  • an employee of your health care provider.

In addition, one of your witnesses must not be related to you by blood, marriage or adoption within the third degree of consanguinity (parents, children, siblings, grandchildren, grandparents, uncles, aunts, nephews, nieces and great-grandchildren).

Kansas

Declaration

Must be signed by two witnesses or notarized. Neither of your witnesses may be:

  • under the age of 18
  • the person who signed your declaration for you, if you were unable to sign it yourself
  • related to you by blood or marriage
  • entitled to any part of your estate by operation of law or under your will, or
  • directly financially responsible for your health care.

Durable Power of Attorney for Health Care Decisions

Must be signed by two witnesses or notarized.

If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18
  • your agent for health care decisions
  • related to you by blood, marriage or adoption
  • entitled to any part of your estate by operation of law or under your will, or
  • directly financially responsible for your health care.

Kentucky

Advance Directive

Must be signed by two witnesses or notarized. Neither of your witnesses nor the notary may be:

  • related to you by blood
  • your beneficiary by operation of Kentucky law
  • your attending physician
  • an employee of a health care facility where you are a patient, unless the employee serves as a notary public, or
  • directly financially responsible for your health

Louisiana

(Nolo does not provide legal information about estate planning in Louisiana.)

Maine

Advance Health Care Directive

The document must be signed by two witnesses. Although the law does not restrict who can serve as a witness, we suggest that your witnesses be at least 18 years old and that your health care agent not act as a witness.

Maryland

Advance Directive

The document must be signed by two witnesses. The person you name as your health care agent cannot serve as a witness. In addition, at least one of your witnesses must be a person who is not entitled to any portion of your estate, and who is not entitled to any financial benefit by reason of your death.

Massachusetts

Document Directing Health Care & Health Care Proxy

Both documents must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18, or
  • your health care agent.

Michigan

Document Directing Health Care

Must be signed by two witnesses. Although the law does not restrict who can serve as a witness, we suggest that your witnesses be at least 18 years old and that your patient advocate not act as a witness.

Patient Advocate Designation

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • your spouse, parent, child, grandchild or sibling
  • your patient advocate
  • your physician
  • an employee of your life or health insurance provider
  • an employee of a health care facility where you are a patient
  • an employee of a home for the aged where you live, or
  • entitled to any portion of your estate by operation of law or under your will.

Minnesota

Health Care Directive

Must be signed by two witnesses or notarized. Neither your witnesses nor the notary may be your health care agent.

If you choose to have the document witnessed, at least one of the witnesses may not be a health care provider or an employee of a provider directly attending to you.

If you choose to have the document notarized, the notary may not be your health care agent.

Mississippi

Advance Health Care Directive

Must be signed by two witnesses or notarized.

If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18
  • your health care agent
  • a health care provider, or
  • an employee of a health care provider or facility.

In addition, one witness must not be related to you by blood, marriage or adoption and must not be entitled to any part of your estate by operation of law or under your will.

Missouri

Declaration

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18, or
  • the person who signed your declaration for you, if you were unable to sign it yourself.

Durable Power of Attorney for Health Care

If you grant your agent power to direct your burial or cremation, your document must be signed in front of two witnesses and notarized. If you do not grant this power, only the notary is necessary.

Montana

Declaration & Durable Power of Attorney for Health Care

Both documents must be signed by two witnesses. Although the law does not restrict who can serve as a witness, we suggest that your witnesses be at least 18 years old and that your health care agent not act as a witness.

Nebraska

Declaration

Must be signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18, or
  • an employee of your life or health insurance provider.

In addition, one witness may not be a director or employee of your treating health care provider.

Durable Power of Attorney for Health Care

If you grant your agent power to direct your burial or cremation, your document must be notarized. If you do not grant your agent the power to direct your burial or cremation, you may choose to have your document signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be:

  • your attorney-in-fact for health care decisions
  • your attending physician
  • your spouse, parent, child, grandchild or sibling
  • your presumptive heir or known devisee, or
  • an employee of your life or health insurance provider.

In addition, one of your witnesses must not be an administrator or employee of your health care provider.

Nevada

Declaration

Must be signed by two witnesses. Although the law does not restrict who can serve as a witness, we suggest that your witnesses be at least 18 years old and that your attorney-in-fact for health care decisions not act as a witness.

Durable Power of Attorney for Health Care Decisions

If you grant your agent power to direct your burial or cremation, your document must be notarized. If you do not grant this power, you may choose to have your document signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18
  • your attorney-in-fact for health care decisions
  • a health care provider
  • an employee of a health care provider
  • the operator of a health care facility, or
  • an employee of the operator of a health care facility.

In addition, one of your witnesses must not be related to you by blood, marriage or adoption and must not be entitled to any part of your estate by operation of law or under your will.

New Hampshire

Advance Directive

Must be signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18
  • your health care agent
  • your attending physician or advanced registered nurse practitioner (ARNP) or a person acting under the direction or control of the attending physician or ARNP
  • your spouse, or
  • entitled to any part of your estate by operation of law or under your will.

In addition, no more than one witness may be a health or residential care provider or such provider’s employee.

New Jersey

Combined Advance Directive for Health Care & Instruction Directive or Proxy Directive

Any document must be signed by two witnesses or notarized.

If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18, or
  • your health care representative.

New Mexico

Advance Health Care Directive

The law does not require that your advance directive be witnessed. However, witnesses are recommended to avoid concerns that the document might be forged, that you were forced to sign it or that it does not genuinely represent your wishes. If you choose to have your document witnessed, we suggest that your witnesses be at least 18 years old.

New York

Document Directing Health Care & Health Care Proxy

Both must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • your health care agent, or
  • the person who signed the declaration for you, if you were unable to sign it for yourself

If you reside in a mental health facility, your witnesses must meet additional requirements. Ask your mental health care provider for more information.

North Carolina

Advance Directive

Must be signed by two witnesses and notarized. Neither of your witnesses may be:

  • related to you by blood or marriage
  • your attending physician or mental health treatment provider
  • a licensed health care provider who is (1) an employee of your attending physician or mental health treatment provider, (2) an employee of the health facility in which you are a patient or (3) an employee of a nursing home or any adult care home where you reside
  • a person entitled to any part of your estate by operation of law or under your will, or
  • a person with a claim against you or your estate.

Health Care Power of Attorney

Must be signed by two witnesses and notarized. Neither of your witnesses may be:

  • under the age of 18
  • related to you by blood or marriage
  • your attending physician or mental health treatment provider
  • a licensed health care provider who is (1) an employee of your attending physician or mental health treatment provider, (2) an employee of the health facility in which you are a patient or (3) an employee of a nursing home or any adult care home where you reside
  • a person entitled to any part of your estate by operation of law or under your will, or
  • a person with a claim against you or your estate.

North Dakota

Must be signed by two witnesses or notarized. Neither the witnesses nor the notary may be:

  • under the age of 18
  • your spouse or another person related to you by blood, marriage or adoption
  • your health care agent
  • a person entitled to any part of your estate upon your death, or
  • a person with a claim against your estate.

In addition, at least one witness must not be a health care or long-term care provider providing you with direct care or an employee of the health care or long-term care provider providing you with direct care. (This restriction does not apply to the notary.)

Ohio

Declaration

Must be signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18
  • related to you by blood, marriage or adoption
  • your attending physician
  • an administrator of a nursing home where you receive care, or
  • the person who signed your declaration, if you were unable to sign it yourself.

Durable Power of Attorney for Health Care

Must be signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18
  • related to you by blood, marriage or adoption
  • your attorney-in-fact
  • your attending physician, or
  • an administrator of a nursing home where you receive care.

Oklahoma

Advance Directive for Health Care

If you grant your agent power to direct your burial or cremation, your document must be signed in front of two witnesses and notarized. If you do not grant this power, only the witnesses are necessary. Neither of your witnesses may be:

  • under the age of 18
  • related to you by blood, marriage or adoption, or
  • a person who might inherit from you.

Oregon

Advance Directive

Must be signed by two witnesses.

Neither of your witnesses may be:

  • your health care representative, or
  • your attending One witness may not be:
  • related to you by blood, marriage or adoption
  • an owner, operator or employee of a health care facility where you are a resident, or
  • a person entitled to any part of your estate upon your death.

Pennsylvania

Declaration & Durable Power of Attorney for Health Care

Both documents must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18, or
  • the person who signed your declaration for you, if you were unable to sign it yourself.

Rhode Island

Declaration

Must be signed by two witnesses. Your witnesses may not be related to you by blood or marriage.

Durable Power of Attorney for Health Care

If you grant your agent power to direct your burial or cremation, your document must be notarized. If you do not grant this power, you may choose to have your document signed by two witnesses or notarized.

If your document will be notarized, the notary may not be:

  • related to you by blood, marriage or adoption, or
  • entitled to any part of your estate by operation of law or under your will.

If you choose to have the document witnessed, neither of your witnesses may be:

  • under the age of 18
  • your health care agent
  • a health care provider
  • an employee of a health care provider
  • the operator of a community care facility, or
  • an employee of an operator of a community care provider.

In addition, one of your witnesses must not be related to you by blood, marriage or adoption and must not be entitled to any part of your estate by operation of law or under your will.

South Carolina

Declaration

Must be signed by two witnesses and notarized. Neither of your witnesses may be:

  • related to you by blood, marriage or adoption
  • your attending physician
  • an employee of your attending physician
  • a person directly financially responsible for your medical care
  • a person entitled to any part of your estate by operation of law or under your will
  • a beneficiary of your life insurance policy, or
  • a person who has a claim against your estate.

No more than one of your witnesses may be an employee of a health care facility where you are a patient. If you are in a hospital or nursing care facility when you sign your declaration, at least one of your witnesses must be an ombudsman designated by the state.

Health Care Power of Attorney

Must be signed by two witnesses and notarized. Neither of your witnesses may be:

  • your health care agent
  • your attending physician
  • an employee of your attending physician
  • related to you by blood, marriage or adoption
  • directly financially responsible for your medical care
  • the beneficiary of an insurance policy on your life
  • a person with a claim against your estate at the time you sign your document, or
  • a person entitled to any portion of your estate by operation of law or under your will.

In addition, only one witness may be an employee of a health facility in which you are a patient.

South Dakota

Living Will Declaration

Must be signed by two witnesses, both of whom are at least 18 years old, and may also be notarized, although notarization is optional.

Durable Power of Attorney for Health Care

Must be signed by two witnesses, both of whom are at least 18 years old.

Tennessee

Advance Health Care Directive

Must be signed by two witnesses or a notary. If you choose to have your document witnessed, both witnesses must be competent adults and neither may be your health care agent. In addition, at least one of your witnesses must not be related to you by blood, marriage or adoption—and must not be entitled to any part of your estate by operation of law or under your will.

Texas

Directive to Physicians and Family or Surrogates

Must be signed by two witnesses. Your witnesses must be at least 18 years old. In addition, at least one of your witnesses may not be:

  • your health care agent
  • related to you by blood or marriage
  • your attending physician
  • an employee of your attending physician
  • an employee of a health care facility in which you are a patient if the employee is providing direct care to you or is an officer, director, partner or business office employee of the health care facility or of any parent organization of the health care facility, or an employee of a health care facility in which you are a patient if the employee is providing direct care to you or is an officer, director, partner or business office employee of the health care facility or of any parent organization of the health care facility, or
  • a person who is entitled to or has a claim against any part of your estate after your death.

Medical Power of Attorney

If you grant your agent power to direct your burial or cremation, your document must be signed by two witnesses and notarized. Your witnesses must be at least 18 years old. In addition, at least one of your witnesses may not be:

  • your health care agent
  • related to you by blood or marriage
  • your attending physician
  • an employee of your attending physician
  • an employee of a health care facility in which you are a patient if the employee is providing direct care to you or is an officer, director, partner or business office employee of the health care facility or of any parent organization of the health care facility, or
  • a person who is entitled to or has a claim against any part of your estate after your death.

If you do not grant your agent power to direct your burial or cremation, you may choose to have your document signed by two witnesses (subject to the requirements, above) or notarized.

Utah

Advance Health Care Directive

Must be signed by one witness. Your witness may not be:

  • under the age of 18
  • your health care agent
  • related to you by blood or marriage
  • a health care provider who is providing care to you
  • an administrator at a health care facility where you are receiving care
  • a person directly financially responsible for your medical care
  • a beneficiary of a life insurance policy, trust, qualified plan, pay-on- death account or transfer-on-death deed that is held, owned, made or established by you or on your behalf
  • entitled to benefit financially upon your death
  • entitled to a right to, or interest in, any of your real or personal property upon your death, or
  • the person who signed your document for you, if you were unable to sign it yourself.

If you grant your agent power to direct your burial or cremation, your document must be signed in front of two witnesses.

Vermont

Advance Directive

Must be signed by two witnesses. Neither witness may be:

  • under the age of 18
  • your health care agent, or
  • your spouse, parent, adult sibling, adult child or adult

In addition, if you are a patient in a hospital, nursing home or residential care facility, a designated person must sign the document after explaining it to you. Ask a patient representative for help with this requirement.

Virginia

Advance Medical Directive

If you grant your agent power to direct your burial or cremation, your document must be signed in front of two witnesses and notarized—and your health care agent must sign the part of the document that grants the power.

If you do not grant your agent power to direct your burial or cremation, only the witnesses are necessary.

Your witnesses must be over the age of 18. In addition, we suggest that your health care agent not act as a witness.

Washington

Health Care Directive

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • related to you by blood or marriage
  • your attending physician
  • an employee of your attending physician
  • an employee of a health care facility where you are a patient
  • a person entitled to any part of your estate by operation of law or under your will, or
  • a person with a claim against yourestate.

Durable Power of Attorney for Health Care

Must be signed by two witnesses or notarized. If you choose to have your document witnessed, neither of your witnesses may be:

  • under the age of 18
  • related to you by blood, marriage or state-registered domestic partnership, or
  • a care provider for you at your home, at an adult family home or at a long-term care facility if you live there.

West Virginia

Living Will & Medical Power of Attorney

Both documents must meet the same requirements: Must be signed by two witnesses and notarized. Neither of your witnesses may be:

  • under the age of 18
  • your health care representative or successor representative
  • the person who signed your document, if you were unable to sign it yourself
  • related to you by blood or marriage
  • your attending physician
  • a person directly financially responsible for your medical care, or
  • a person entitled to any part of your estate by operation of law or under your will.

Wisconsin

Declaration to Physicians

Must be signed by two witnesses. Neither of your witnesses may be:

  • related to you by blood, marriage or adoption
  • your domestic partner
  • your health care provider
  • an employee of your health care provider, other than a chaplain or a social worker
  • an employee of an inpatient health care facility where you are a patient, other than a chaplain or a social worker
  • a person directly financially responsible for your medical care
  • a person who has a claim against your estate, or
  • a person entitled to any part of your estate by operation of law or under your will.

Power of Attorney for Health Care

Must be signed by two witnesses. Neither of your witnesses may be:

  • under the age of 18
  • your health care agent
  • related to you by blood, marriage or adoption
  • your domestic partner
  • your health care provider
  • an employee of your health care provider, other than a chaplain or a social worker
  • an employee of an inpatient health care facility where you are a patient, other than a chaplain or a social worker
  • a person directly financially responsible for your medical care, or
  • a person with a claim against your estate.

Wyoming

Advance Health Care Directive

Must be signed by two witnesses or notarized. If you choose to have the document witnessed, both witnesses must be competent adults who know you personally. In addition, neither of your witnesses may be:

  • your health care agent
  • a treating health care provider
  • an employee of a treating health care provider
  • the operator of a community care facility
  • an employee of an operator of a community care facility
  • the operator of a residential care facility, or
  • an employee of an operator of a residential care facility.

Learn More

Learn more about health care directives on the Living Wills & Medical Powers of Attorney section of Nolo.com.

With Nolo’s Quicken WillMaker Plus, you can make a health care directive that conforms to the laws of your state. WillMaker health care directives print out with clear, plain English instructions about how to finalize your document to make it legal and binding.

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