Advance directive formats

There are many different advance directive formats. Some follow forms outlined in state laws. Others are created by lawyers or even the patients themselves. State law and the courts decide whether these documents are valid. All states and the District of Columbia have laws about advance directives, but the documents may be called different names in different states.

Most states do not require the use of a specific form, but they do have legal requirements about what must be included and how the document is set up. Because the words on a standard form may not be clear and may not reflect your personal wishes, you should review and change the words to clearly state your personal values, priorities, and wishes. You should also know your state’s requirements for writing legal advance directives. For example, states define the minimum age required to have a directive. All states also require that at least one adult not related by blood, marriage, or adoption witness your signature and date on the advance directive. Some states require 2 witnesses. You can usually get sample forms for advance directives from your state, your state bar association, or from Caring Connection (part of the National Hospice and Palliative Care Organization). See the “To learn more” section for contact information.

Before you create an advance directive, you will want to talk with your doctor, your loved ones, and at least one person that you want to choose as your proxy or agent (substitute decision-maker). Tell them about your situation, wishes, and fears. You need to talk about your choices with them because they’re the ones who will help put your wishes into effect if you are unable to do so.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: May 21, 2015 Last Revised: May 18, 2016

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