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California Advance Directive Form

The California advance directive form allows individuals to prepare for end-of-life health care and medical emergencies by appointing a health care agent (also known as a “surrogate”) and relaying instructions regarding medical treatments. These instructions specify the types of life-sustaining treatments that the principal wishes to allow and under which circumstances.

For instance, the principal will be able to record whether or not they wish to be resuscitated from cardiac failure or receive artificial nutrition if they are in a persistent vegetative state. If the principal (the individual for whom the directive is made) is physically or medically incapacitated, their surrogate will be authorized to make health care decisions in their place and in respect to their instructions.

Agent’s Duties§ 4714

LawsUniform Health Care Decisions Act

Signing Requirements (§ 4701) – Two (2) Witnesses or Notary Public. The witnesses cannot be the principal’s health care provider or the operators/employees of a care facility.

Statutory Form§ 4701


State Definition

Statute – § 4605

“Advance health care directive” or “advance directive” means either an individual health care instruction or a power of attorney for health care.


Registering

Laws – § 4800

Individuals can register their advance directives in the Advance Health Care Directive Registry by attaching their advance directive to a registration form and filing them with the Secretary of State. Alternatively, the directive’s location can be indicated on the registration form.