Can the directive be signed electronically?

Yes in most states: electronic signatures meet ESIGN (15 U.S.C. ch. 96) and UETA requirements where adopted, provided the signing process captures intent, consent, attribution, and retention. Confirm state exceptions for testamentary or court filings.

Are witnesses or a notary required?

It depends on state law. Many states accept either two witnesses or notarization; some require two non‑interested witnesses. Check your state statute or health department guidance before execution.

Who can serve as my health care agent?

An adult you trust may serve unless state law disqualifies certain individuals (e.g., treating physician). Choose someone willing to honor your values and available during medical decision moments.

How do I revoke or change the directive?

You may revoke by executing a new directive, signing a formal revocation, or communicating intent to revoke to your agent and providers per state rules; provide updated copies to clinicians.

Where should I store the signed directive?

Provide copies to your agent, primary care clinician, and hospital; keep the original in a safe but accessible place and consider registering with any state advance directive registry where available.

Can a vendor handle PHI for signing?

Yes if the vendor offers a HIPAA Business Associate Agreement (BAA) and uses encryption plus audit trails; confirm the vendor’s compliance certifications before transmitting protected health information.

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Advance Health Care Directive

Advance Health Care Directive

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

REVOCATION OF ADVANCE HEALTH CARE DIRECTIVE

I, Declarant, having executed an Advance Health-Care Directive on the day of , regarding my decisions and choices concerning my health care. Pursuant to Alaska Statutes § 13.52.020, which provides that an Advance Health Care Directive may be revoked at any time by (1) a signed writing or (2) by personally informing the supervising health care provider of an intent to revoke, I hereby revoke all or those parts of that Advance Health-Care Directive as indicated below:

All of the Advanced Health Care Directive.

Part 1: Durable Power of Attorney for Health Care Decisions.

Part 2: Instructions for Health Care.

Part 3: Anatomical Gift at Death.

Part 4: Mental Health Treatment.

Part 5: Primary Physician.

This is my written revocation as indicated above of my Advance Health-Care Directive and is provided to all persons to whom I have provided a copy of my Advance Directive.

DATED this the day of , .

Signature of Declarant:

Printed Name of Declarant:

Address of Declarant:

What an Advance Health Care Directive Is and When it Applies

An Advance Health Care Directive is a written legal document that records your preferences for medical treatment and appoints a health care agent to make decisions if you cannot speak for yourself. It commonly includes a living will section describing life-sustaining treatment choices and a durable power of attorney for health care naming a surrogate decision‑maker. The document is used by clinicians, hospitals, and caregivers to guide care in emergencies, chronic illness, or end‑of‑life situations and is enforceable under state law when properly executed.

Why an Advance Health Care Directive Matters

Completing an Advance Health Care Directive preserves your treatment preferences, reduces uncertainty for family and clinicians, and directs who may legally consent to or refuse medical interventions on your behalf. Properly executed directives can shorten decision timelines and reduce disputes during serious illness.

Who Typically Prepares and Relies on an Advance Health Care Directive

The Advance Health Care Directive is used by adults of any age who want to document health preferences and designate a decision‑maker.

Patients with chronic or progressive conditions — individuals who want clear instructions for future care and to reduce family uncertainty.
Adults planning for potential incapacity — people undergoing major surgery or those who want to ensure their values guide care.
Healthcare providers and legal counsel — clinicians rely on directives for treatment decisions; attorneys assist with state‑specific execution rules.

Keep a signed copy accessible to your agent, clinician, and family; verify state execution rules and storage locations.

Essential Components to Include in an Advance Health Care Directive

A professional Advance Health Care Directive integrates agent designation, granular treatment preferences, organ donation choices, instruction on life‑sustaining treatments, surrogate succession, and any HIPAA or privacy authorizations to enable medical record access.

Health Care Agent

Name your primary health care agent and include contact details plus alternate agents and succession instructions to ensure someone can act if the first choice is unavailable.

Living Will

Specify preferences for life‑sustaining treatments such as CPR, mechanical ventilation, dialysis, and artificial nutrition so clinicians can align care with your values.

Organ Donation

State whether you consent to organ or tissue donation and provide any restrictions or timing preferences to assist transplant coordinators and medical examiners.

Comfort Care

Outline priorities for pain management, palliative care, and hospice to guide clinicians when curative treatment is no longer the goal.

HIPAA Release

Include specific authorization language permitting your agent to access medical records and speak with providers, which avoids privacy‑related delays in information sharing.

Specific Instructions

Add condition‑based directives (e.g., irreversible coma, terminal illness) and any religious or cultural care preferences to reduce ambiguity during critical decisions.

Legal and Security Considerations for the Advance Health Care Directive

HIPAA protection: Include HIPAA release language; health records remain protected under HIPAA.

ESIGN & UETA: Electronic execution is valid under ESIGN (15 U.S.C. ch. 96) and UETA where adopted.

Encryption: Use TLS 1.2/1.3 and AES‑256 for storage and transit of digital copies.

Audit trail: Maintain timestamps, IP logs, and signer attribution for evidentiary support.

BAA availability: For electronic workflows involving PHI, use a vendor that offers a HIPAA BAA.

21 CFR readiness: If used in FDA contexts, ensure 21 CFR Part 11 controls where required.

Step‑by‑Step: How to Complete Your Advance Health Care Directive

Follow these sequential steps to prepare, sign, and distribute an Advance Health Care Directive so it is available when needed.

01

Gather details: Collect IDs, contact info, and medical history for accurate entries.
02

Choose an agent: Select someone you trust and discuss their responsibilities beforehand.
03

Specify choices: Write clear, condition‑based treatment preferences to guide clinicians.
04

Execute properly: Sign with required witness or notary steps according to your state law.

Setting Up an Electronic Advance Health Care Directive Workflow

Configure these workflow settings when preparing the directive online to ensure secure signing, identity verification, and proper record delivery.

Field	Configuration
Signer authentication	Use email link or SMS code; consider two‑factor for higher assurance.
Witness fields	Add witness signature places and affirmations when state requires witnesses.
Notary block	Include a notary acknowledgement section if notarization may be needed.
Document retention	Enable secure storage and exportable audit trail for legal evidence.

Where an Executed Advance Health Care Directive Should Go

After signing, provide copies to key parties and attach the directive to your medical record when possible to ensure accessibility in clinical settings.

Primary care physician: Give a signed copy for placement in your medical chart.
Hospital records: Provide a copy on admission or add to your patient portal.
Health care agent: Leave a signed original or certified copy with your agent.
Attorney or family: Retain a copy with your legal documents and notify family members.

Technical and File Requirements for Electronic Advance Health Care Directives

Use secure PDF or DOCX files and choose a platform that supports required signer authentication, audit trails, and HIPAA controls.

File formats: PDF and DOCX supported for stable, printable records.
Integrations: Works with EHR and cloud systems like Salesforce or Google Workspace.
Authentication: Email, SMS, or stronger methods depending on jurisdictional requirements.

Verify the vendor offers HIPAA BAAs when the workflow handles protected health information and confirm exportable audit trails for legal admissibility.

eSignature Platform Comparison for Completing an Advance Health Care Directive

Pricing and feature availability vary; choose a platform that supports HIPAA BAAs, audit trails, and the authentication level required by your state for medical directives.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Yes, limited	Yes, limited
Bulk Send	Yes	Yes	Yes	Yes	Varies by plan
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently Asked Questions About Advance Health Care Directives

Answers to common execution, witness, electronic signing, and revocation questions to reduce confusion and ensure your directive is effective.

Need help? Contact support

Can the directive be signed electronically?
Yes in most states: electronic signatures meet ESIGN (15 U.S.C. ch. 96) and UETA requirements where adopted, provided the signing process captures intent, consent, attribution, and retention. Confirm state exceptions for testamentary or court filings.
Are witnesses or a notary required?
It depends on state law. Many states accept either two witnesses or notarization; some require two non‑interested witnesses. Check your state statute or health department guidance before execution.
Who can serve as my health care agent?
An adult you trust may serve unless state law disqualifies certain individuals (e.g., treating physician). Choose someone willing to honor your values and available during medical decision moments.
How do I revoke or change the directive?
You may revoke by executing a new directive, signing a formal revocation, or communicating intent to revoke to your agent and providers per state rules; provide updated copies to clinicians.
Where should I store the signed directive?
Provide copies to your agent, primary care clinician, and hospital; keep the original in a safe but accessible place and consider registering with any state advance directive registry where available.
Can a vendor handle PHI for signing?
Yes if the vendor offers a HIPAA Business Associate Agreement (BAA) and uses encryption plus audit trails; confirm the vendor’s compliance certifications before transmitting protected health information.

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