Witness and Signing Requirements for Health Care Directives

Your state might require health care directives to be notarized or signed by witnesses.

Updated by Jeff Burtka, Attorney George Mason University Law School

Updated 8/06/2024

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A health care directive allows you to set out your wishes for medical care in case you later can't make your own medical decisions because of illness, an accident, or advanced age. There are two main types of health care directives: a living will and a health care power of attorney. In some states, these two documents are combined into a single form—often called an "advance directive." To make your health care directive legally valid, you must follow your state's rules about signing, witnessing, and notarizing your document.

In This Article

Signing Your Health Care Directive
Witnessing and Notarization of a Health Care Directive
Common Health Care Directive Finalization Terms
Your State's Rules for Finalizing Health Care Directives
Learn More

Signing Your Health Care Directive

Every state requires that you sign your health care directives (or direct another person to sign for you if you can't physically sign the documents). But don't 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 directives who is too ill or weak to sign them, you or another person may sign the documents at that person's direction. You and the person making the health care directive should appear together in front of the witnesses or notary public (depending on what state law requires). That way, someone can observe the signing and confirm, if it is ever necessary, that your signature is what the document maker wanted and directed.

Witnessing and Notarization of a Health Care Directive

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 (the living will) and the document naming your agent (the health care power of attorney). See below for links to your state's rules.

Witnessing the Signing of a Health Care Directive

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.

States have 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 isn't 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 don't have a personal or professional conflict of interest that could affect your health care.

Notarization of a Health Care Directive

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.

Common Health Care Directive 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.

Agent. A person you designate to make health care decisions for you.
Attorney-in-fact: Another name for an agent.
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.
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 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 hasn't 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, and then more distant relatives.
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.
Principal. The person who creates a health care power of attorney.
Proxy. Another name for a health care agent.
Representative. Another name for a health care agent.
Surrogate. Another name for a health care agent.

Your State's Rules for Finalizing Health Care Directives

Here are the finalization rules for each state. Select your state to learn about your state's laws.

State	Document Name(s) and Signing Requirements
Alabama	*Advance Directive for Health Care* Two witnesses are required. Neither of your witnesses may be: younger than 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 state law or under your will, or directly financially responsible for your medical care. (Ala. Code § 22-8A-4 (2024).)
Alaska	*Advance Health Care Directive* If you grant your agent power to direct your burial or cremation, your document must be notarized. If you don't 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 state law or under a will or codicil (amendment to a will). (Alaska Stat. §§ 13.52.010, 13.75.010 (2024).)
Arizona	*Living Will and 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. Whether you have one or two witnesses, your witness may not be: your health care agent, or any person involved in providing your health care. If you have only one witness, your witness also can't 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 your document notarized, the notary may not be: your health care agent, or any person involved in providing your health care. (Ariz. Rev. Stat. §§ 36-3221, 36-3261 (2024).)
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* You may choose to have the durable power of attorney for health care 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. (Ark. Code §§ 20-6-103, 20-17-202 (2024).)
California	*Advance Directive for Health Care* Must either be signed by two adult 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.) (Cal. Prob. Code §§ 4673, 4674, 4675 (2024).)
Colorado	*Declaration as to Medical or Surgical Treatment and Medical Durable Power of Attorney* The declaration as to medical or surgical treatment must be signed by two witnesses or 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 can't be patients of that facility. A medical durable power of attorney technically doesn't need witnesses or a notary public, but it's generally safer to have it witnessed or notarized. (Colo. Rev. Stat. §§ 15-14-506, 15-18-105, 15-18-106 (2024.)
Connecticut	*Health Care Instructions and Appointment of Health Care Representative* Must be signed by two witnesses, one of whom can't be your health care representative. You and your witnesses may also sign in front of a notary public, but you aren't required to do so. If you reside in a government facility for mental health, addiction, or developmental services, one witness can't be associated with the facility, and at least one must be a physician, advanced practice nurse, or psychologist with specialized training in mental illness or developmental disabilities. (Conn. Gen. Stat. §§ 19a-575a, 19a-576, 19a-577 (2024).) *Document Concerning Withholding or Withdrawal of Life Support Systems* Must be signed by two witnesses. Although the law doesn't 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 representative not act as a witness. (Conn. Gen. Stat. § 19a-575 (2024).)
Delaware	*Advance Health Care Directive* The document must be signed by two witnesses. Neither of your witnesses may be: younger than 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. (Del. Code tit. 16, § 2503 (2024).) 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 Department of Health and Social Services. (Del. Code tit. 16, § 2505 (2024).)
District of Columbia	*Declaration* Must be signed by two witnesses. Neither of your witnesses may be: younger than 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. (D.C. Code § 7-622 (2024).) If you are a patient in a skilled care facility, one witness must be a patient advocate or ombudsman. (D.C. Code § 7-623 (2024).) *Durable Power of Attorney for Health Care* Must be signed by two witnesses. Neither of your witnesses may be: younger than 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. (D.C. Code §§ 21-2205, 21-2207 (2024).)
Florida	*Living Will* Must be signed by two witnesses, one of whom must not be your spouse or related to you by blood. (Fla. Stat. § 765.302 (2024).) *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. (Fla. Stat. § 765.202 (2024).)
Georgia	*Advance Directive for Health Care* Must be signed by two witnesses. Neither of your witnesses may be: younger than 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 health care facility where you are receiving health care. (This witness is still prohibited from being directly involved in your health care.) (Ga. Code § 31-32-5 (2024).)
Hawaii	*Advance Health Care Directive* 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. (Haw. Rev. Stat. § 327E-3 (2024).)
Idaho	*Advance Care Planning Document* Idaho law doesn't 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 doesn't 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. (Idaho Code § 39-4510 (2024).)
Illinois	*Living Will* Must be signed by two witnesses. Neither of your witnesses may be: younger than 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. (755 Ill. Comp. Stat. § 35/3 (2024).) *Durable Power of Attorney for Health Care* Must be signed by one witness. Your witness may not be: younger than 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 above an owner, operator, or relative of an owner or operator of a health care facility in which you are a patient or resident (an operator 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, your agent, or your alternate agent, regardless of whether the relationship is by blood, marriage, or adoption, or your agent or alternate agent for health care. (755 Ill. Comp. Stat. § 45/4-5.1 (2024).)
Indiana	*Living Will Declaration* Must be signed by two witnesses or a notary public. If you use witnesses instead of a notary, neither of your witnesses may be: younger than 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. (Ind. Code § 16-36-4-8 (2024).) *Advance Directive* Must be signed by two adult witnesses or a notary public. If you can't physically sign your document, the person who signs it for you can't be a witness or the notary. If you use witnesses instead of a notary, one of the witnesses can't be your spouse or relative. (Ind. Code § 16-36-7-28 (2024).)
Iowa	*Declaration and Durable Power of Attorney for Health Care* Both documents must be signed by two witnesses or notarized. If you choose to use witnesses instead of a notary, your health care agent can't be a witness for your durable power of attorney for health care. For both documents, neither of your witnesses may be: younger than 18 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). (Iowa Code §§ 144A.3, 144B.3 (2024).)
Kansas	*Declaration* Must be signed by two witnesses or notarized. Neither of your witnesses may be: younger than 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. (Kan. Stat. § 65-28,103 (2024).) *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: younger than 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. (Kan. Stat. § 58-629 (2024).)
Kentucky	*Advance Directive* Must be signed by two adult witnesses or notarized. Neither of your witnesses nor the notary may be: related to you by blood entitled to inherit from you 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. (Ky. Rev. Stat. § 311.625 (2024).)
Louisiana	(Nolo doesn't provide legal information about estate planning in Louisiana.)
Maine	*Advance Health Care Directive* The document must be signed by two witnesses. Although the law doesn't 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. (Me. Rev. Stat. tit. 18-C, § 5-803 (2024).)
Maryland	*Advance Directive* The document must be signed by two witnesses. The person you name as your health care agent can't serve as a witness. In addition, at least one of your witnesses must not be entitled to any portion of your estate or entitled to any financial benefit because of your death. (Md. Code Health-Gen., § 5-602 (2024).)
Massachusetts	*Health Care Proxy* Must be signed by two witnesses. Neither of your witnesses may be: younger than 18, or your health care agent. (Mass. Gen. Laws ch. 201D, § 2 (2024).)
Michigan	*Living Will* Michigan technically doesn't have living wills, but many people still make them. And health care providers often honor them—even though they might not be legally required to. Because there's no statute authorizing living wills in Michigan, there are no formal requirements for executing one. However, you should consider having it signed by two adult witnesses who aren't family members or your patient advocate. *Patient Advocate Designation* Must be signed by two witnesses. Neither of your witnesses may be: younger than 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. (Mich. Comp. Laws § 700.5506 (2024).)
Minnesota	*Health Care Directive* Must be signed by two witnesses or notarized. Neither of your witnesses nor the notary may be your health care agent or alternate 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. (Minn. Stat. § 145C.03 (2024).)
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: younger than 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 entitled to any part of your estate by operation of law or under your will and must not be related to you by blood, marriage, or adoption. (Miss. Code § 41-41-205 (2024).)
Missouri	*Declaration* Must be signed by two witnesses. Neither of your witnesses may be: younger than 18, or the person who signed your declaration for you, if you were unable to sign it yourself. (Mo. Rev. Stat. § 459.015 (2024).) *Durable Power of Attorney for Health Care* This document must be notarized. (Mo. Rev. Stat. §§ 404.705, 404.810 (2024).)
Montana	*Declaration* Must be signed by two witnesses. Although the law doesn't 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. (Mo. Rev. Stat. § 50-9-103 (2024).) *Durable Power of Attorney for Health Care* A health care power of attorney doesn't need witnesses or a notary to be valid in Montana. But we suggest that you use a notary if possible. (Mo. Rev. Stat. § 72-5-501 (2024).)
Nebraska	*Declaration* Must be signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be: younger than 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. (Neb. Rev. Stat. § 20-404 (2024).) *Durable Power of Attorney for Health Care* You may choose to have your document signed by two witnesses or notarized. Your attorney-in-fact can't be your notary. If you choose to have the document witnessed, neither of your witnesses may be: your spouse, parent, child, grandchild, or sibling your presumptive heir or known devisee (in other words, people who will inherit from you) your attending physician a member of your mental health treatment team your romantic or dating partner your attorney-in-fact for health care decisions, 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. (Neb. Rev. Stat. §§ 30-3404, 30-3405 (2024).)
Nevada	*Declaration* Must be signed by two witnesses. Although the law doesn't 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. (Nev. Rev. Stat. § 449A.433 (2024).) *Durable Power of Attorney for Health Care Decisions* 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: younger than 18, or an owner, operator, or employee of a health care facility where you reside. (Nev. Rev. Stat. § 162A.790 (2024).)
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: younger than 18 your health care agent your attending physician, physician assistant (PA), or advanced registered nurse practitioner (ARNP) or a person acting under the direction or control of the attending physician, PA, 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 that provider's employee. (N.H. Rev. Stat. §§ 137-J:2, 137-J:14 (2024).)
New Jersey	*Combined Advance Directive for Health Care, Instruction Directive, 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: younger than 18, or your health care representative. (N.J. Stat. §§ 26:2H-56, 26:2H-58 (2024).)
New Mexico	*Advance Health Care Directive* The law doesn't require that your advance directive be witnessed or notarized. However, using a notary or witness could prevent concerns that the document is forged, that you were forced to sign it, or that it doesn't genuinely represent your wishes. If you choose to have your document witnessed, we suggest that your witnesses be at least 18 years old. (N.M. Stat. § 24-7A-2 (2024).)
New York	*Document Directing Health Care (Living Will) and Health Care Proxy* Both must be signed by two witnesses. Neither of your witnesses may be: younger than 18 your health care agent, or the person who signed the document 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. (N.Y. Pub. Health Law § 2981 (2024).)
North Carolina	*Health Care Power of Attorney and Advance Directive* Must be signed by two witnesses and notarized. Neither of your witnesses may be: younger than 18 related to you or your spouse 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. (N.C. Gen. Stat. §§ 32A-16, 90-321 (2024).)
North Dakota	*Health Care Directive* Must be signed by two witnesses or notarized. Neither the witnesses nor the notary may be: younger than 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 a person who is directly responsible for your medical care you attending physician, 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 doesn't apply to the notary.) (N.D. Cent. Code § 23-06.5-05 (2024).)
Ohio	*Declaration* Must be signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be: younger than 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. (Ohio Rev. Code § 2133.02 (2024).) *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: younger than 18 related to you by blood, marriage, or adoption your attorney-in-fact or alternate attorney-in-fact your attending physician, or an administrator of a nursing home where you receive care. (Ohio Rev. Code § 1337.12 (2024).)
Oklahoma	*Advance Directive for Health Care* Your document must be signed in front of two witnesses. Neither of your witnesses may be: younger than 18 related to you by blood, marriage, or adoption, or a person who might inherit from you. (Okla. Stat. tit. 63, § 3104.4 (2024).)
Oregon	*Advance Directive* Must be signed by two witnesses or notarized. Neither of your witnesses may be: your health care representative or alternate health care representative, or your attending physician or attending health care provider. If you are a patient in a long-term care facility when you sign the document, one of the witnesses must be designated by the facility according to Department of Human Services rules. (Or. Rev. Stat. § 127.515 (2024).)
Pennsylvania	*Living Will and Durable Power of Attorney for Health Care* Both documents must be signed by two witnesses. Neither of your witnesses may be: younger than 18 the person who signed your declaration for you, if you were unable to sign it yourself, or your health care provider or an agent of your health care provider. (20 Pa. Cons. Stat. §§ 5442, 5452 (2024).)
Rhode Island	*Declaration* Must be signed by two witnesses. Your witnesses may not be related to you by blood or marriage. (R.I. Gen. Laws § 23-4.11-3 (2024).) *Durable Power of Attorney for Health Care* 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: younger than 18 your health care agent or alternate 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. (R.I. Gen. Laws § 23-4.10-2 (2024).)
South Carolina	*Declaration* Must be signed by two witnesses and notarized. One of your witnesses may be the notary public. 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. (S.C. Code § 44-77-40 (2024).) *Health Care Power of Attorney* Must be signed by two witnesses. You may have it notarized in addition to having two witnesses, but using a notary public isn't required. 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 care facility where you are a patient. (S.C. Code § 62-5-503 (2024).)
South Dakota	*Living Will Declaration* Must be signed by two witnesses—both of whom are at least 18 years old—or notarized. (S.D. Codified Laws § 34-12D-2 (2024).) *Durable Power of Attorney for Health Care* Must be signed by two witnesses—both of whom are at least 18 years old—or notarized. (S.D. Codified Laws § 59-7.2-1 (2024).)
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. (Tenn. Code § 68-11-1803 (2024).)
Texas	*Directive and Medical Power of Attorney* 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 an employee of a health care facility in which you are a patient if the employee is an officer, director, partner, or business office employee of the health care facility or 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. (Tex. Health & Safety Code §§ 166.003, 166.154 (2024).) For a medical power of attorney, you may choose to have your document notarized instead of having it signed by two witnesses. (Tex. Health & Safety Code §§ 166.003, 166.154 (2024).)
Utah	*Advance Health Care Directive* Must be signed by one witness. Your witness may not be: younger than 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. (Utah Code 75-2a-107 (2024).)
Vermont	*Advance Directive* Must be signed by two witnesses. Neither witness may be: younger than 18 your health care agent, or your spouse, parent, adult sibling, child, or grandchild In addition, if you are a patient in a hospital, nursing home, or residential care facility, an ombudsman or other designated person must sign the document after explaining it to you. Ask a patient representative for help with this requirement. (Vt. Stat. tit. 18, § 9703 (2024).)
Virginia	*Advance Medical Directive* Your witnesses must be over the age of 18. In addition, we suggest that your health care agent not act as a witness. (Va. Code §§ 54.1-2982, 54.1-2983 (2024).)
Washington	*Health Care Directive* Must be notarized or signed by two witnesses. If you choose to have your document witnessed, neither of your witnesses may be: younger than 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 your estate. (Wash. Rev. Code § 70.122.030 (2024).) *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: younger than 18 related to you by blood, marriage, or state-registered domestic partnership, or a care provider for you at your home, an adult family home where you live, or a long-term care facility where you live. (Wash. Rev. Code § 11.125.050 (2024).)
West Virginia	*Living Will and 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: younger than 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. (W. Va. Code § 16-30-4 (2024).)
Wisconsin	*Declaration to Physicians* Must be signed by two witnesses. Neither of your witnesses may be: younger than 18 related to you by blood, marriage, or adoption 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. (Wis. Stat. § 154.03 (2024).) *Power of Attorney for Health Care* Must be signed by two witnesses. Neither of your witnesses may be: younger than 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. (Wis. Stat. § 155.10 (2024).)
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. (Wyo. Stat. § 35-22-403 (2024).)

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In This Article

Signing Your Health Care Directive
Witnessing and Notarization of a Health Care Directive
Common Health Care Directive Finalization Terms
Your State’s Rules for Finalizing Health Care Directives
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Finalization Requirements for Health Care Directives