California Advance Directive Form

Create Document

A California advance directive allows an individual to indicate their treatment preferences and select an agent to oversee their health care in the event of incapacitation. The individual (principal) can use the document to choose their primary physician, indicate their organ donation preferences, and how to dispose of their remains.

California Advance Directive Form

A California advance directive allows an individual to indicate their treatment preferences and select an agent to oversee their health care in the event of incapacitation. The individual (principal) can use the document to choose their primary physician, indicate their organ donation preferences, and how to dispose of their remains.

Create Document
PDF
PDF

Last updated May 8th, 2024

Document Preview

A California advance directive allows an individual to indicate their treatment preferences and select an agent to oversee their health care in the event of incapacitation. The individual (principal) can use the document to choose their primary physician, indicate their organ donation preferences, and how to dispose of their remains.

Downloads: 1,702
  1. Home »
  2. Power of Attorney »
  3. California »
  4. Advance Directive

Signing Requirements

The advance directive must be acknowledged by a notary public or signed by two witnesses.[1] The following individuals may not serve as witnesses[2]:

  • The health care agent
  • The owner or staff of a senior living institution
  • The owner or staff of a community care facility
  • Any health care provider or employee caring for the patient

Furthermore, if a patient in a skilled nursing facility executes a written advance health care directive, it is not effective unless a patient advocate or ombudsman signs it as a witness.[3]

Advance Directive (Preview)

Revocation

As long as the patient is mentally sound, they may revoke the powers of their selected agent either in writing or by informing the health care provider.[4]

The advance directive portion of the form may be revoked in any way as long as the patient is clear in their intent to do so.

Registering

Individuals may elect to register their advance health care directive with the Secretary of State by[5]:

  1. Completing the Registration of Written Advance Health Care Directive form.
  2. Attaching a copy of the Advance Health Care Directive form and/or indicating on the registration form if it serves to notify where the advance directive will be stored for safekeeping.
  3. Attaching a check payable to the Secretary of State with the appropriate filing fee.
  4. Mailing everything to:

Secretary of State
Special Filings Unit
P.O. Box 942870
Sacramento, CA
94277-2870

Registration of organ and tissue preferences is done via the Donate Life California online portal.

Sources