An advance health care directive is the all-in-one document most states now recommend: it appoints your health care agent (the job of a medical power of attorney) and records your treatment instructions (the job of a living will) in a single form your providers file once.
This template builds both parts: your agent and alternate with immediate or capacity-triggered authority, plus your end-of-life, nutrition, and organ donation choices. Download it in Word and PDF, then execute it under your state's witnessing rules.
Why one combined directive beats two separate documents
Hospitals work from whatever paper reaches the chart. Two separate documents signed in different years can conflict, get separated, or leave gaps; a single directive keeps the agent appointment and the instructions consistent and in one place. It is also the statutory format in a growing list of states, led by California's Health Care Decisions Law, and the structure used by most hospital admission packets.
| Function | Advance directive | Separate documents |
|---|---|---|
| Names an agent | Part One | Medical power of attorney |
| Treatment instructions | Part Two | Living will |
| Risk of internal conflict | Low | Higher |
| Pages for the hospital chart | One document | Two documents |
Fixed instructions or agent discretion: pick your balance
The hardest design question in any directive is how much to write down. Detailed instructions bind providers but cannot anticipate every scenario; broad agent discretion adapts to reality but asks a lot of one person. This template lets you choose: a comfort-care directive, a prolong-life directive, or an explicit delegation to your agent guided by your values. Whichever you pick, talk it through with your agent: the conversation is what makes the document work at the bedside.
Executing and distributing your directive
Witnessing rules are strict and state-specific. The common pattern: two adult witnesses, neither of whom is your agent, your provider, or an employee of your facility, with at least one witness unrelated to you and not an heir; a notary is accepted as an alternative in many states. Residents of skilled nursing facilities often need a patient advocate or ombudsman as an additional witness. After signing, distribute copies widely: your agent, alternate, physician, hospital, and family. Providers honor copies, so circulation beats safekeeping.
Health care only
An advance health care directive gives no authority over finances or property. Pair it with a durable financial power of attorney for a complete incapacity plan.
Frequently asked questions
Is an advance directive different from a living will?
A living will is one component: your treatment instructions. An advance health care directive combines those instructions with the appointment of a health care agent in a single document. If you already have a living will and a medical power of attorney, a combined directive can replace both.
Who cannot be my health care agent?
In most states: your treating physician, employees of the facility where you receive care (unless related to you), and, in some states, anyone who serves as a witness to the directive. Choose someone independent of your care team.
Should my agent's authority start immediately or at incapacity?
Immediate authority (with your consent while capable) lets your agent talk to providers, schedule care, and handle paperwork right away, and avoids disputes about whether you have lost capacity. Capacity-triggered authority keeps everything in your hands until physicians certify otherwise. Both are valid; the immediate option is increasingly common.
Does my advance directive work in another state?
Most states honor out-of-state directives that were validly executed where signed. If you spend serious time in two states, sign a directive that meets the stricter state's witnessing rules, or execute one in each state with identical choices.
How often should I update my advance directive?
Review it at every major life event: a new diagnosis, a move to another state, the death or estrangement of your agent, or a change in your values. Signing a new directive revokes the old one; destroy outdated copies so only the current version circulates.