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Understanding state-specific language in the Advance Health Care Directive

This article outlines variations at the state level for the Advance Health Care Directive (AHCD).

The Advance Health Care Directive (AHCD) does the same core job in every state: it lets you name someone to make health care decisions for you and share your treatment wishes. What changes by state is the exact legal wording, document title, and sometimes signing requirements or extra companion forms.

This article outlines what is nuanced on a state-by-state basis for the Advance Health Care Directive form.

What stays the same in most states

Most AHCD forms include:

  • Naming a health care agent (and backups)

  • When your agent can act

  • Your treatment choices (including end-of-life preferences)

  • Organ donation / after-death wishes

  • Revocation language (canceling prior directives)

  • Witness and/or notary signature sections

What changes by state

State

Form name(s)

When agent authority starts

End-of-life wording highlights

Who must sign

AL (Alabama)

Health Care Proxy + Living Will

State-specific incapacity standard (physician findings)

Standard choices + terminal/permanent unconsciousness concepts

2 witnesses

AK (Alaska)

Advance Health Care Directive

Choice in form

Standard combined language

2 witnesses or notary

AZ (Arizona)

Health Care Power of Attorney + Living Will

Choice in form

Standard combined language

1 witness or notary

AR (Arkansas)

Advance Directive

Choice in form

Standard combined language

2 witnesses or notary

CA (California)

Advance Health Care Directive

Choice in form (immediate or on incapacity)

California statutory language (near death/unconsciousness/burden-benefit + pain relief)

2 witnesses or notary

CO (Colorado)

Advance Medical Directive

State-specific: while lacking “decisional capacity”

Standard combined language

2 witnesses or notary

CT (Connecticut)

Advance Health Care Directive

State-specific incapacity finding by provider

Standard combined language

2 witnesses (notary acknowledgment may appear)

DE (Delaware)

Advance Health-Care Directive

State-specific: while lacking capacity

Standard combined language

2 witnesses

DC (District of Columbia)

Durable Power of Attorney for Health Care + Declaration

State-specific: upon and during incapacitation

Standard combined language

2 witnesses

FL (Florida)

Advance Directive (Living Will format)

In surrogate form: choice in form (immediate or on incapacity)

Terminal condition, end-stage condition, persistent vegetative state

2 witnesses

GA (Georgia)

Advance Directive for Health Care

Choice in form

Standard combined language

2 witnesses

HI (Hawaii)

Durable POA for Health-Care Decisions + Advance Health-Care Directive

Choice in form

Standard combined language

2 witnesses or notary

ID (Idaho)

Advance Care Planning Document

Choice in form

Standard combined language

Notary authentication used in this version

IL (Illinois)

Health Care Agency + Declaration

Choice in form

Standard combined language

2 witnesses

IN (Indiana)

Appointment of Health Care Representative + Treatment Wishes

Choice in form

Standard combined language

2 witnesses or notary

IA (Iowa)

Durable POA for Health Care + Declaration

Choice in form

Standard combined language

2 witnesses or notary

KS (Kansas)

Durable POA for Health Care Decisions + Declaration

Choice in form

Standard combined language

2 witnesses or notary

KY (Kentucky)

Advance Directive

State-specific physician incapacity determination

Standard combined language

2 witnesses or notary

LA (Louisiana)

Procuration + Declaration

Choice in form

Standard combined language

2 witnesses

ME (Maine)

Advance Health Care Directive

Choice in form

Standard combined language

2 witnesses

MD (Maryland)

Advance Directive

Choice in form

Standard combined language

2 witnesses

MA (Massachusetts)

Health Care Proxy

State-specific incapacity standard (MA law)

Standard combined language

2 witnesses

MI (Michigan)

Patient Advocate Designation

State-specific: when unable to participate in decisions

Standard combined language

2 witnesses

MN (Minnesota)

Health Care Power of Attorney + Health Care Directive

Choice in form

Standard combined language

2 witnesses or notary

MS (Mississippi)

Advance Health Care Directive

Choice in form

Standard combined language

2 witnesses or notary

MO (Missouri)

Durable Power of Attorney for Health Care

Choice in form (POA section)

End-of-life declaration is in separate document

Notary required

MT (Montana)

Advance Health Care Directive

State-specific: when no longer able to make medical decisions

Standard combined language

2 witnesses

NE (Nebraska)

Power of Attorney for Health Care

State-specific incapacity determination

Standard combined language

2 witnesses or notary

NV (Nevada)

Durable POA for Health Care Decisions

Choice in form

Standard combined language

2 witnesses or notary

NH (New Hampshire)

New Hampshire Advance Directive Form

Choice in form

Includes life-sustaining treatment and permanently unconscious wording

2 witnesses or notary

NJ (New Jersey)

Advance Directive for Health Care

State-specific: for decisions where capacity is lacking

Standard combined language

2 witnesses or notary

NM (New Mexico)

Advance Health-Care Directive

Choice in form

Standard combined language

Witness route used in this version

NY (New York)

Health Care Proxy

State-specific: when unable to make own decisions

Standard combined language

2 witnesses

NC (North Carolina)

Health Care Power of Attorney + Advance Directive for a Natural Death

State-specific physician incapacity trigger

Incurable/irreversible condition; life-prolonging measures

2 witnesses and notary

ND (North Dakota)

Health Care Directive

Choice in form

Standard combined language

2 witnesses or notary

OH (Ohio)

Durable Power of Attorney for Health Care

State-specific: loss of informed decision-making capacity

Terminal condition + permanently unconscious

2 witnesses or notary

OK (Oklahoma)

Advance Directive for Health Care

State-specific physician + second physician determination

Standard combined language

2 witnesses

OR (Oregon)

Advance Directive

Choice in form

Standard combined language

2 witnesses or notary

PA (Pennsylvania)

Health Care Power of Attorney

Choice in form

Standard combined language

2 witnesses

RI (Rhode Island)

Rhode Island statutory health care agent form

Timing is less explicit in main form text

Life-sustaining procedure language (statutory RI format)

2 witnesses or 1 notary

SC (South Carolina)

Health Care Power of Attorney

State-specific: during mental incompetence

Standard combined language

2 witnesses (notary acknowledgment may appear)

SD (South Dakota)

Durable POA for Health Care + Living Will

State-specific: when incapable of informed consent

Standard combined language

2 witnesses preferred; notary-only has limited effect

TN (Tennessee)

Durable POA for Health Care + Living Will

Choice in form

Standard combined language

2 witnesses or notary

TX (Texas)

Advance Directive (Texas Directive to Physicians and Family or Surrogates)

In MPOA: physician certifies lack of capacity

Terminal condition + irreversible condition + life-sustaining treatment language

2 witnesses or notary

UT (Utah)

Advance Health Care Directive

Choice in form

Standard combined language

1 witness

VT (Vermont)

Advance Directive

Choice in form

Standard combined language

2 witnesses

VA (Virginia)

Advance Directive

State-specific: incapable of informed decision

Standard combined language

2 witnesses

WA (Washington)

Power of Attorney for Health Care + Health Care Directive

Choice in form

Standard combined language

2 witnesses or notary

WV (West Virginia)

Medical Power of Attorney + Living Will

State-specific: inability to give/withhold informed consent

Standard combined language

2 witnesses and notary

WI (Wisconsin)

Power of Attorney for Health Care + Declaration to Health Care Professionals (Wisconsin Living Will)

Choice in form (immediate or statutory incapacity)

Terminal condition, persistent vegetative state, feeding tube choices

2 witnesses (same-time signing rule)

WY (Wyoming)

Advance Health Care Directive

Choice in form

Standard combined language

2 witnesses or notary

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