Advance directive forms by state

Official source Advance Directive for Health Care

Quoted excerpt Witnesses (need two witnesses to sign) I am witnessing this form because I believe this person to be of sound mind. I did not sign the person’s signature, and I am not the health care proxy. I am not related to the person by blood, adoption, or marriage and not entitled to any part of his or her estate. I am at least 19 years of age and am not directly responsible for paying for his or her medical care.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Portable Physician Do Not Attempt Resuscitation Order. This is a narrower DNAR order.

Official source Not published

Official source Court referral to Advance Health Care Directive forms and instructions

Quoted excerpt Not published

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Not published

Official source Not published

Official source Health Care Power of Attorney

Quoted excerpt At least one adult witness, not to include the proxy if there is one, OR a notary public must witness you signing this document. DO NOT have the documents signed by both a witness and a notary, just pick one. If you do not know a notary or cannot pay for one, a witness is legally accepted. Witnesses or notary public CANNOT be anyone who is: (a) under the age of 18 (b) related to you by blood, adoption, or marriage (c) entitled to any part of your estate (d) appointed as your agent (e) involved in providing your health care at the time this form is signed

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source POLST form referral

Official source Not published

Official source Advance Care Plan

Quoted excerpt Your signature should either be witnessed by two competent adults or notarized. If witnessed, neither witness should be the person you appointed as your agent, and at least one of the witnesses should be someone who is not related to you or entitled to any part of your estate.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions POLST does not replace an advance directive.

Official source Arkansas Physician Orders for Life-Sustaining Treatment

Official source Not published

Official source Statutory Advance Health Care Directive

Quoted excerpt After completing this form, sign and date the form at the end. The form must be signed by two qualified witnesses or acknowledged before a notary public.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The form lists excluded witnesses. At least one witness must satisfy its additional family and estate-interest declaration.

Conditions Skilled nursing facility patients have an additional patient advocate or ombudsman statement.

Official source Physician Orders for Life-Sustaining Treatment. Voluntary medical-order referral.

Official source California Statutory Power of Attorney form

Official source Not published

Quoted excerpt (a) Signed by the declarant in the presence of two witnesses; or (b) Signed by the declarant and acknowledged before a notary public or other individual authorized by law to take acknowledgments, unless a court determines that this subsection (1)(b) should not apply to the declaration in the interest of justice. (2) For the purposes of this section, a person specified in section 15-18-105 shall not be a witness, notary public, or other individual authorized by law to take acknowledgments.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The quoted execution rule applies to a declaration as to medical treatment. The statute lists excluded witnesses and a separate route when the declarant cannot physically sign.

Official source Medical Orders for Scope of Treatment. Statutory form requirements.

Official source Statutory form power of attorney

Official source Combined advance directives form. Its sections are optional.

Quoted excerpt (a) Any person eighteen years of age or older may appoint a health care representative by executing a document in accordance with section 19a-575a or section 19a-577 , signed and dated by such person in the presence of two adult witnesses who shall also sign the document. The person appointed as representative shall not act as witness to the execution of such document or sign such document.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The quoted rule concerns appointment of a health care representative. Specified mental-health and developmental-services facilities have additional witness qualifications.

Official source Medical Orders for Life-Sustaining Treatment

Official source Statutory power of attorney short and long forms

Official source Optional Advance Health-Care Directive

Quoted excerpt (d) A power of attorney for health care must be in a record, signed by the individual creating the power, and signed by an adult witness who satisfies all of the following: (1) Reasonably believes the act of the individual to create the power of attorney is voluntary and knowing. (2) Is not the agent appointed by the individual. (3) Is not the agent’s spouse, domestic partner, or cohabitant. (4) If the individual resides or is receiving care in a nursing home or long-term care facility, is not the owner, operator, employee, or contractor of the nursing home or long-term care facility. (5) Is present when the individual signs the power of attorney or when the individual represents that the power of attorney reflects the individual’s wishes. (e) A witness under subsection (d) of this section is considered present if the witness and the individual are any of the following: (1) Physically present in the same location. (2) Using electronic means that allow for real time audio and visual transmission and communication in real time to the same extent as if the witness and the individual were physically present in the same location. (3) Able to speak to and hear each other in real time through audio connection if the identity of the individual is personally known to the witness or the witness is able to authenticate the identity of the individual by receiving accurate answers from the individual that enable the authentication.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions A specified mental-health direction restricting revocation has a separate-record requirement and two physically present adult witnesses.

Official source Delaware Medical Orders for Scope of Treatment

Official source Statutory durable personal power of attorney form

Official source Sample durable power of attorney for health care

Quoted excerpt (c) A durable power of attorney for health care shall be dated and signed by the principal and 2 adult witnesses who affirm that the principal was of sound mind and free from duress at the time of signing. The 2 adult witnesses shall not include the principal, the health-care provider of the principal or an employee of the health-care provider of the principal. (d) Of the 2 adult witnesses referred to in subsection (c) of this section, at least 1 shall not be related to the principal by blood, marriage or adoption and shall not be entitled to any part of the estate of the principal by a current will or operation of law.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Medical Orders for Scope of Treatment

Official source Statutory power of attorney form. Additional real-estate notice requirements may apply.

Official source Suggested designation of health care surrogate

Quoted excerpt A written document designating a surrogate to make health care decisions for a principal or receive health information on behalf of a principal, or both, shall be signed by the principal in the presence of two subscribing adult witnesses. A principal unable to sign the instrument may, in the presence of witnesses, direct that another person sign the principal’s name as required herein. An exact copy of the instrument shall be provided to the surrogate. (2) The person designated as surrogate shall not act as witness to the execution of the document designating the health care surrogate. At least one person who acts as a witness shall be neither the principal’s spouse nor blood relative.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Do Not Resuscitate Order. This is a narrower resuscitation order.

Official source Not published

Official source Attorney general referral to Georgia Advance Directive for Health Care

Quoted excerpt Not published

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Physician Orders for Life-Sustaining Treatment

Official source Not published

Official source Advance Health Care Directive

Quoted excerpt Have two qualified witnesses or a notary public witness your signature.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions Witnesses cannot be the health care agent, a health care provider or a health care facility employee. One witness cannot be a relative or have inheritance rights.

Official source Provider Orders for Life-Sustaining Treatment

Official source Not published

Official source Idaho Advance Directive and update resources

Quoted excerpt (1) Any competent person aged eighteen (18) years or older may execute an advance care planning document (ACPD). Such document must contain the mandatory elements set forth in this section. Any provisions of an ACPD that are left blank by a person executing the document shall be deemed intentional and shall not invalidate the document. The department of health and welfare may create and promulgate an optional form for the ACPD. Such form is not mandatory. To be considered a valid ACPD, a document must include: (a) The person’s name, date of birth, telephone number, and mailing address; (b) The signature of the person for whom the ACPD is created or the authorized agent of such person; and (c) The date on which the document was signed.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The statute lists witness details and notarization as optional ACPD contents.

Official source Physician Orders for Scope of Treatment

Official source Not published

Official source Statutory short form power of attorney for health care

Quoted excerpt (i) Sign the form in front of a witness. See the form for a list of who can and cannot witness it. (ii) Ask the witness to sign it, too. (iii) There is no need to have the form notarized.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The quoted rule concerns the statutory health care form. Its witness must satisfy the full age and disqualification rules.

Conditions The source describes a separate qualifying nonstatutory health care power that need not be witnessed.

Official source Practitioner Orders for Life-Sustaining Treatment

Official source Not published

Official source Health department guidance and sample-form referrals. No official or mandatory form must be followed.

Quoted excerpt Not published

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Physicians Order for Scope of Treatment

Official source Not published

Official source Durable power of attorney for health care form

Quoted excerpt b. The durable power of attorney for health care contains the date of its execution and is witnessed or acknowledged by one of the following methods: (1) Is signed by at least two individuals who, in the presence of each other and the principal, witnessed the signing of the instrument by the principal or by another person acting on behalf of the principal at the principal’s direction. (2) Is acknowledged before a notarial officer within this state as provided in chapter 9B. 2. The following individuals shall not be witnesses for a durable power of attorney for health care: a. A health care provider attending the principal on the date of execution. b. An employee of a health care provider attending the principal on the date of execution. c. The individual designated in the durable power of attorney for health care as the attorney in fact. d. An individual who is less than eighteen years of age. 3. At least one of the witnesses for a durable power of attorney for health care shall be an individual who is not a relative of the principal by blood, marriage, or adoption within the third degree of consanguinity.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Iowa Physician Orders for Scope of Treatment

Official source Iowa Statutory Power of Attorney form

Official source Durable power of attorney for health care decisions form

Quoted excerpt (e) A durable power of attorney for health care decisions shall be: (1) Dated and signed in the presence of two witnesses at least 18 years of age neither of whom shall be the agent, related to the principal by blood, marriage or adoption, entitled to any portion of the estate of the principal according to the laws of intestate succession of this state or under any will of the principal or codicil thereto, or directly financially responsible for the principal's health care; or (2) acknowledged before a notary public.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Not published

Official source Not published

Official source Statutory Living Will Directive. KRS 311.625

Quoted excerpt An advance directive shall be in writing, dated, and signed by the grantor, or at the grantor's direction, and either witnessed by two (2) or more adults in the presence of the grantor and in the presence of each other, or acknowledged before a notary public or other person authorized to administer oaths. None of the following shall be a witness to or serve as a notary public or other person authorized to administer oaths in regard to any advance directive made under this section: (a) A blood relative of the grantor; (b) A beneficiary of the grantor under descent and distribution statutes of the Commonwealth; (c) An employee of a health care facility in which the grantor is a patient, unless the employee serves as a notary public; (d) An attending physician of the grantor; or (e) Any person directly financially responsible for the grantor's health care.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Medical Orders for Scope of Treatment (MOST)

Official source Statutory Form Power of Attorney. KRS 457.420

Official source Illustrative declaration concerning life-sustaining procedures. R.S. 40 section 1151.2

Quoted excerpt A written declaration shall be signed by the declarant in the presence of two witnesses.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions This is the written declaration rule. Witnesses must be competent adults who are unrelated by blood or marriage and have no entitlement to the relevant estate.

Official source Louisiana Physician Order for Scope of Treatment (LaPOST)

Official source Not published

Official source Optional Advance Health Care Directive. Title 18-C section 5-805

Quoted excerpt The power must be in writing and signed by the principal and 2 witnesses. Notwithstanding any law validating electronic or digital signatures, signatures of the principal and witnesses must be made in person and not by electronic means.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The quoted rule concerns the health care power of attorney. A separate statute permits a narrow remote-signing process for infectious-disease isolation in a hospital or residential health care facility.

Official source Not published

Official source Not published

Official source Maryland Advance Directive form and instructions

Quoted excerpt Except as provided in subparagraph (ii) of this paragraph or paragraph (3) of this subsection, a written or electronic advance directive shall be dated, signed by or at the express direction of the declarant, and subscribed by two witnesses in the physical presence or electronic presence of the declarant.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The health care agent cannot witness. At least one witness must lack a known estate entitlement or financial benefit at death.

Conditions The linked statute includes an unwitnessed video exception and recognizes directives executed during the specified earlier emergency order. Check the complete statute with a lawyer.

Official source Medical Orders for Life-Sustaining Treatment (MOLST)

Official source Statutory Personal Financial Power of Attorney. Estates and Trusts section 17-202

Official source DPH Health Care Proxy form resources

Quoted excerpt Said health care proxy shall be in writing signed by such adult or at the direction of such adult in the presence of two other adults who shall subscribe their names as witnesses to such signature. The witnesses shall affirm in writing that the principal appeared to be at least eighteen years of age, of sound mind and under no constraint or undue influence. No person who has been named as health care agent in a health care proxy shall act as a witness to the execution of such proxy. For the purposes of this section, every adult shall be presumed to be competent and every health care proxy shall be presumed to be properly executed unless a court determines otherwise.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions DPH offers partner-provided forms. The quoted execution rule concerns the health care proxy.

Conditions The legislature directs a transition from MOLST to the national POLST model. Follow the DPH program referral for current form guidance.

Official source Medical Orders for Life-Sustaining Treatment (MOLST). POLST transition

Official source Not published

Official source Attorney General referrals for patient advocate and medical power of attorney forms

Quoted excerpt Not published

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The advance-directive links are Attorney General referrals to forms from other organizations.

Official source Michigan Physician Orders for Scope of Treatment (MI-POST)

Official source Michigan Statutory Form Power of Attorney

Official source Suggested Health Care Directive. Minnesota Statutes 145C.16

Quoted excerpt This document must be signed by me. It also must either be verified by a notary public (Option 1) OR​ witnessed by two witnesses (Option 2). It must be dated when it is verified or witnessed.​

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The notary cannot be a named agent or alternate. Witnesses must be adults and cannot be named agents or alternates. Only one witness may provide direct care or work for a provider giving direct care that day.

Official source Provider Orders for Life-Sustaining Treatment (POLST)

Official source Statutory Short Form Power of Attorney. Minnesota Statutes 523.23

Official source Not published

Quoted excerpt Not published

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The health department hospice standards describe treatment instructions and designation of a decision maker. This source is context for a lawyer discussion.

Official source Not published

Official source Not published

Official source Sample declaration concerning death-prolonging procedures. RSMo 459.015

Quoted excerpt The declaration made pursuant to sections 459.010 to 459.055 shall be: (1) In writing; (2) Signed by the person making the declaration, or by another person in the declarant's presence and by the declarant's expressed direction; (3) Dated; and (4) If not wholly in the declarant's handwriting, signed in the presence of two or more witnesses at least eighteen years of age neither of whom shall be the person who signed the declaration on behalf of and at the direction of the person making the declaration.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The linked form is the statutory treatment declaration. The statute makes witnesses conditional on whether the declaration is wholly handwritten.

Conditions The cited TPOPP and POLST provision requires department review and approval. The linked statute contains its additional conditions.

Official source Transportable Physician Orders for Patient Preferences (TPOPP) and POLST. Statutory recognition

Official source Not published

Official source My Choices Advance Directive

Quoted excerpt Ask two people to watch you sign and have them sign below. If you can, it’s best to sign this document in front of a Notary Public.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The form asks two witnesses to sign. Its witnesses attest they are over eighteen and observed voluntary signing. The form recommends notarization.

Official source Provider Orders for Life-Sustaining Treatment (POLST)

Official source Statutory Form Power of Attorney. MCA 72-31-353

Official source Statutory Power of Attorney for Health Care. Nebraska Revised Statutes 30-3408

Quoted excerpt The power of attorney for health care shall (1) be in writing, (2) identify the principal, the attorney in fact, and the successor attorney in fact, if any, (3) specifically authorize the attorney in fact to make health care decisions on behalf of the principal in the event the principal is incapable, (4) show the date of its execution, and (5) be witnessed and signed by at least two adults, each of whom witnesses either the signing and dating of the power of attorney for health care by the principal or the principal's acknowledgment of the signature and date, or be signed and acknowledged by the principal before a notary public who shall not be the attorney in fact or successor attorney in fact.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The statute lists disqualified witnesses, including specified relatives, estate beneficiaries, certain care professionals, a romantic partner, and the attorney in fact. It also limits provider employees to one witness.

Official source Not published

Official source Statutory Power of Attorney form and instructions

Official source Statutory Advance Health-Care Directive. NRS 162A.855

Quoted excerpt A power of attorney for health care must be signed by the principal. The principal’s signature on the power of attorney for health care must be: (a) Acknowledged before a notary public; or (b) Witnessed by two adult witnesses. 3. Neither of the witnesses to a principal’s signature may be the owner, operator or employee of a nursing home if the principal resides in the nursing home.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Physician Order for Life-Sustaining Treatment (POLST)

Official source Statutory Form Power of Attorney. NRS 162A.620

Official source Statutory Advance Directive. RSA 137-J section 20

Quoted excerpt You must sign this form in the physical presence of 2 witnesses or a notary or justice of the peace for it to be valid. The witnesses cannot be your agent, spouse, heir, or anyone named in your will, trust or who may otherwise receive your property at your death, or your attending medical practitioner or anyone who works directly under them. Only one witness can be employed by your health or residential care provider.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Provider Orders for Life-Sustaining Treatment (POLST)

Official source Statutory Power of Attorney. RSA 564-E section 301

Official source Proxy Directive form

Quoted excerpt You can choose to get your advance directive notarized, in which case you don't need additional witnesses. Or you can choose to sign and date your advance directive in front of two adult witnesses who must also sign and date the document.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The person appointed as health care representative cannot witness the advance directive.

Official source Practitioner Orders for Life-Sustaining Treatment (POLST)

Official source Not published

Official source Not published

Quoted excerpt Not published

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Medical Orders for Scope of Treatment (MOST). Health department program referral

Official source Statutory Form Power of Attorney. NMSA 45-5B-301

Official source Health Care Proxy form and instructions

Quoted excerpt Two witnesses must watch you sign your health care proxy form and say that you appeared to sign willingly. Neither your agent nor your alternate agent can serve as a witness. You do not need to have the form notarized.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Medical Orders for Life-Sustaining Treatment (MOLST)

Official source Statutory Short Form Power of Attorney. General Obligations Law 5-1513

Official source Statutory Health Care Power of Attorney. G.S. 32A-25.1

Quoted excerpt Except as provided in G.S. 32A-16.1, a written instrument that substantially meets the requirements of this Article, that is signed in the presence of two qualified witnesses, and acknowledged before a notary public, pursuant to which an attorney-in-fact or agent is appointed to act for the principal in matters relating to the health care of the principal.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The statute defines qualified witnesses and preserves a limited earlier emergency waiver. A lawyer should check the execution of an existing instrument.

Conditions The health department limits MOST form downloads to physicians and licensed health care facilities. Use its program page to discuss MOST with a clinician.

Official source Medical Orders for Scope of Treatment (MOST). Official program referral

Official source Statutory Form Power of Attorney. G.S. 32C-3-301

Official source Optional statutory health care directive form

Quoted excerpt A health care directive must be signed by the principal and that signature must be verified by a notary public or at least two or more subscribing witnesses who are at least eighteen years of age.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The statute has care-provider restrictions and excludes specified agents, relatives, estate beneficiaries and other financial interests from serving as notaries or witnesses. Read the complete execution section.

Official source Not published

Official source Not published

Official source Not published

Quoted excerpt If witnessed for purposes of division (A)(1)(b) of this section, a durable power of attorney for health care shall be witnessed by at least two individuals who are adults and who are not ineligible to be witnesses under this division. Any person who is related to the principal by blood, marriage, or adoption, any person who is designated as the attorney in fact or alternate attorney in fact in the instrument, the attending physician of the principal, and the administrator of any nursing home in which the principal is receiving care are ineligible to be witnesses. The witnessing of a durable power of attorney for health care shall involve the principal signing, or acknowledging the principal's signature, at the end of the instrument in the presence of each witness. Then, each witness shall subscribe the witness's signature after the signature of the principal and, by doing so, attest to the witness's belief that the principal appears to be of sound mind and not under or subject to duress, fraud, or undue influence. If acknowledged for purposes of division (A)(1)(b) of this section, a durable power of attorney for health care shall be acknowledged before a notary public, who shall make the certification described in section 147.53 of the Revised Code and also shall attest that the principal appears to be of sound mind and not under or subject to duress, fraud, or undue influence.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The execution excerpt concerns the durable power of attorney for health care. Witnesses have relationship, agency, physician and nursing-home restrictions.

Official source DNR Comfort Care and DNR Comfort Care Arrest

Official source Statutory form power of attorney under section 1337.60

Official source Statutory Advance Directive for Health Care

Quoted excerpt The advance directive shall be signed by the declarant and witnessed by two individuals who are eighteen (18) years of age or older who are not legatees, devisees, or heirs at law.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Oklahoma Physician Orders for Life-Sustaining Treatment

Official source Statutory financial power of attorney under section 15-1003

Official source Oregon Health Authority advance directive forms

Quoted excerpt You must sign this form for it to be effective. You must also have it witnessed by two witnesses or a notary. Your appointment of a health care representative is not effective until the health care representative accepts the appointment.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions Witnesses must meet the form declaration. The representative or alternate and the attending health care provider cannot act as witnesses.

Official source Physician Orders for Life-Sustaining Treatment

Official source Not published

Official source Combined living will and health care power of attorney example

Quoted excerpt A health care power of attorney must be: (1) dated and signed by the principal by signature or mark or by another individual on behalf of and at the direction of the principal if the principal is unable to sign but specifically directs another individual to sign the health care power of attorney; and (2) witnessed by two individuals, each of whom is 18 years of age or older. (c) Witnesses.-- (1) An individual who signs a health care power of attorney on behalf of and at the direction of a principal may not witness the health care power of attorney. (2) A health care provider and its agent may not sign a health care power of attorney on behalf of and at the direction of a principal if the health care provider or agent provides health care services to the principal.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The quoted execution rule concerns a health care power of attorney. A person signing for the principal cannot also witness it.

Official source Pennsylvania POLST forms and program guidance

Official source Not published

Official source Statutory durable power of attorney for health care

Quoted excerpt THIS POWER OF ATTORNEY WILL NOT BE VALID UNLESS IT IS SIGNED BY ONE NOTARY PUBLIC OR TWO (2) QUALIFIED WITNESSES WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The form excludes agents, providers and specified facility staff as witnesses. At least one witness or the notary must also make the nonrelative and estate-interest declaration.

Official source Medical Orders for Life Sustaining Treatment

Official source Statutory short form power of attorney under section 18-16-2

Official source Statutory health care power of attorney under section 62-5-504

Quoted excerpt be signed by at least two persons, each of whom witnessed either the signing of the health care power of attorney or the principal's acknowledgment of his signature on the health care power of attorney. Each witness must state in a declaration as set forth in Section 62-5-504 that, at the time of the execution of the health care power of attorney, to the extent the witness has knowledge, the witness is not related to the principal by blood, marriage, or adoption, either as a spouse, lineal ancestor, descendant of the parents of the principal, or spouse of any of them; not directly financially responsible for the principal's medical care; not entitled to a portion of the principal's estate upon his decease under a will of the principal then existing or as an heir by intestate succession; not a beneficiary of a life insurance policy of the principal; and not appointed as health care agent or successor health care agent in the health care power of attorney; and that no more than one witness is an employee of a health care facility in which the principal is a patient, no witness is the attending physician or an employee of the attending physician, or no witness has a claim against the principal's estate upon his decease;

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The statutory form also contains a notarial acknowledgment. Read both the form and the complete witness declarations.

Official source Physician Orders for Scope of Treatment

Official source Not published

Official source Optional statutory living will declaration

Quoted excerpt The declaration must be signed by the declarant, or by another at the declarant's direction, and witnessed by two adults, or by a notary public who shall thereafter notarize the declaration.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Medical Order for Scope of Treatment

Official source Statutory form power of attorney under section 59-12-41

Official source Advance Directive for Health Care

Quoted excerpt Your signature must either be witnessed by two competent adults (“Block A”) or by a notary public (“Block B”). Neither witness may be the person you appointed as your agent or alternate, and at least one of the witnesses must be someone who is not related to you or entitled to any part of your estate.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Physician Orders for Scope of Treatment

Official source Not published

Official source Medical Power of Attorney Designation of Health Care Agent

Quoted excerpt You Must Date And Sign This Power Of Attorney. You May Sign It And Have Your Signature Acknowledged Before A Notary Public Or You May Sign It In The Presence Of Two Competent Adult Witnesses.)

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions At least one witness must satisfy the form's exclusions for agency, relatives, estate interests, the attending physician and specified facility staff.

Official source Out-of-Hospital Do-Not-Resuscitate order

Official source Statutory Durable Power of Attorney

Official source Optional advance health care directive under section 75A-9-110

Quoted excerpt You need a witness if you are using this form to name an Agent. The witness must be an adult and cannot be the person you are naming as Agent or the Agent's spouse or someone the Agent lives with as a couple. If you live or are receiving care in a nursing home, the witness cannot be an employee or contractor of the home or someone who owns or runs the home.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The witness rule quoted here concerns naming an agent. The law has additional witness restrictions and specified remote-presence rules.

Official source Not published

Official source Statutory form power of attorney under section 75A-2-301

Official source Health department advance directive form referrals

Quoted excerpt The advance directive shall be dated, executed by the principal or by another individual in the principal’s presence at the principal’s express direction if the principal is physically unable to do so, and signed by two or more witnesses at least 18 years of age, who shall sign and affirm that the principal appeared to understand the nature of the document and to be free from duress or undue influence at the time the advance directive was signed.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The law restricts relatives and agents as witnesses. It also has remote-witness conditions and extra explanation safeguards for nursing-home, residential-care and hospital execution.

Official source DNR and Clinician Orders for Life-Sustaining Treatment

Official source Not published

Official source Suggested statutory advance directive under section 54.1-2984

Quoted excerpt A written advance directive shall be signed by the declarant in the presence of two subscribing witnesses and may (i) specify the health care the declarant does or does not authorize; (ii) appoint an agent to make health care decisions for the declarant; and (iii) specify an anatomical gift, after the declarant's death, of all of the declarant's body or an organ, tissue or eye donation pursuant to Article 2 (§ 32.1-291.1 et seq.) of Chapter 8 of Title 32.1.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Durable Do Not Resuscitate Program

Official source Not published

Official source Statutory health care directive under RCW 70.122.030

Quoted excerpt The directive shall be signed by the declarer and acknowledged before a notary public or other individual authorized by law to take acknowledgments or signed by the declarer in the presence of two witnesses not related to the declarer by blood or marriage and who would not be entitled to any portion of the estate of the declarer upon declarer's decease under any will of the declarer or codicil thereto then existing or, at the time of the directive, by operation of law then existing. In addition, a witness to a directive shall not be the attending physician, an employee of the attending physician or a health facility in which the declarer is a patient, or any person who has a claim against any portion of the estate of the declarer upon declarer's decease at the time of the execution of the directive.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Portable Orders for Life Sustaining Treatment

Official source Not published

Official source Optional statutory living will and medical power of attorney forms

Quoted excerpt A living will, medical power of attorney, or combined medical power of attorney and living will made pursuant to this article shall be: (1) In writing; (2) executed by the principal or by another person in the principal’s presence at the principal’s express direction if the principal is physically unable to do so; (3) dated; (4) signed in the presence of two or more witnesses eat least 18 years of age; and (5) signed and attested by such witnesses whose signatures and attestations shall be acknowledged before a notary public.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Conditions The law excludes specified relatives, estate interests, the attending physician and named health care representatives as witnesses. A beneficiary-knowledge exception appears in the full section.

Official source Portable Orders for Scope of Treatment

Official source Statutory form power of attorney under section 39B-3-101

Official source Power of Attorney for Health Care

Quoted excerpt Two witnesses are required. Witnesses must be at least 18 years of age, not related to you by blood, marriage, domestic partnership, or adoption, and not directly financially responsible for your health care. A witness cannot be a health care provider who is serving you at the time the document is signed or an employee of the health care provider unless the employee is a chaplain or social worker. A witness cannot be an employee of an inpatient health care facility in which you are a patient, unless the employee is a chaplain or social worker. A witness cannot be your health care agent nor have a claim on any portion of your estate.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source Emergency Care DNR order and DNR bracelet program

Official source Wisconsin statutory power of attorney for finances and property

Official source Not published

Quoted excerpt The durable power of attorney must be acknowledged before a notarial officer or must be signed by at least two (2) witnesses, each of whom witnessed either the signing of the instrument by the principal or the principal's acknowledgement of the signature or of the instrument, each witness making the following declaration in substance: I declare under penalty of perjury under the laws of Wyoming that the person who signed or acknowledged this document is known to me to be the principal, and the principal signed or acknowledged this document in my presence. (c) None of the following shall be used as a witness for a power of attorney for health care: (i) A treating health care provider or employee of the provider; (ii) The attorney-in-fact nominated in the writing; (iii) The operator of a community care facility or employee of the operator or facility; (iv) The operator of a residential care facility or employee of the operator or facility.

Read the full rule Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney.

Official source WyoPOLST portable medical orders

Official source Statutory form power of attorney under section 3-9-301