Health care directive in Alabama: form, signing and who decides

The form, who can witness, who can be your agent and who decides if you have no directive in Alabama.

Checked against official sources: October 31, 2026.

Short answer

Advance Directive for Health Care (Living Will and Health Care Proxy)

Official form
Advance Directive for Health Care (Living Will and Health Care Proxy), Ala. Code § 22-8A-4(h)
How to sign
Signed in front of two witnesses (no notary)
Who decides without a directive
Yes

The document and its form

Document
Advance Directive for Health Care (Living Will and Health Care Proxy)
Official form
Advance Directive for Health Care (Living Will and Health Care Proxy), Ala. Code § 22-8A-4(h)Published by Alabama Legislature; no current state agency copy foundVersion: Statutory text (Acts 1997-187 and later amendments)

You do not have to use it.

Living will

Living will (Section 1 of the Advance Directive for Health Care)

Part of the directive.

In the living will part you say whether you want life-sustaining treatment and tube feeding if you are terminally ill or injured or permanently unconscious. If you have both a living will and a health care proxy, the proxy's decisions take precedence unless your documents say otherwise.

Law: Ala. Code § 22-8A-4(h); Ala. Code § 22-8A-4(a), (g), (h)

Signing rules

How to sign

Put the directive in writing, date it, and sign it in front of two qualified witnesses who are at least 19. If you name a health care proxy, the proxy must accept in writing, and the acceptance is attached to the directive.

Who signs

Signed by you, or by another person in your presence and at your express direction, and dated.

Notary
Not required
Witnesses
2
Who cannot witness

Two or more witnesses, each at least 19 years old. A witness may not be: the person who signed for you; your health care proxy; related to you by blood, adoption or marriage; entitled to any part of your estate under intestate succession or your will or codicil; or directly financially responsible for your medical care.

Law: Ala. Code § 22-8A-4(b), (c)

Who can be your agent and what the agent can do

Who cannot be your agent

Your health care provider, or a nonrelative employee of your health care provider, may not act as your health care proxy or attorney in fact for health care. The proxy must be a competent adult.

Law: Ala. Code §§ 22-8A-4(b)(4), 26-1A-404(c)(5)

When the agent starts

The advance directive becomes effective when your attending physician decides you can no longer understand, appreciate and direct your medical treatment, and two physicians (one the attending physician) have examined you and documented that you have a terminal illness or injury or are permanently unconscious. A health care attorney in fact under § 26-1A-404 acts when, in the attending physician's opinion, you can no longer give directions to health care providers.

Law: Ala. Code § 22-8A-4(d)

Decisions an agent cannot make

Tube feeding and fluids may be withheld or withdrawn only if the directive specifically authorizes it. An attorney in fact under a health care power of attorney may not consent to psychosurgery, sterilization, abortion not necessary to preserve your life, or involuntary hospitalization or treatment for mental illness, and may make life-sustaining treatment decisions only if specifically authorized and in the manner of the Natural Death Act. The directive has no effect during a known pregnancy.

Law: Ala. Code § 22-8A-4(a), (b); Ala. Code § 26-1A-404(c)(1)-(2); § 22-8A-4(e)

Revoking and conflicting documents

Revoking your agent

You can revoke the directive, including the naming of your proxy, at any time: by destroying or defacing it; by a signed and dated written revocation; or by saying so in front of a witness 19 or older who signs and dates a writing confirming it (a spoken revocation takes effect when the doctor or provider receives that writing).

Revoking your instructions

The same methods revoke the living will part.

Telling others

It is your responsibility to give copies of the directive to your doctor and providers; tell them and your proxy about a revocation. No one is liable for not acting on a revocation they did not actually know about.

Divorce ends a spouse's authority
Yes · Divorce rules in Alabama (Divorce Law Map)
Conflicting documents

If you have both a living will and a proxy designation, the proxy's decisions about life-sustaining treatment and tube feeding take precedence unless your living will or proxy designation says otherwise.

Law: Ala. Code § 22-8A-4(g)

Law: Ala. Code §§ 22-8A-5, 22-8A-4(b)(3), (f); Ala. Code §§ 26-1A-404(c)(3)

If you have no directive

Who decides without a directive

If there is no directive or no available proxy, a surrogate can decide about life-sustaining treatment and tube feeding, in consultation with the attending physician, but only if two physicians certify a terminal illness or injury or permanent unconsciousness and the other conditions in the law are met. The surrogate must certify, on a State Board of Health form signed before two witnesses at least 19, that people in equal or higher classes were contacted and consented or did not object.

  • A court-appointed guardian specifically authorized to make life-sustaining treatment decisions
  • Spouse (unless legally separated or in a divorce case)
  • An adult child
  • A parent
  • An adult sibling
  • The nearest surviving adult relatives
  • If no relatives can be found, a committee of the treating physician and the facility's ethics committee, acting unanimously

Law: Ala. Code § 22-8A-11

Other states, registry and medical orders

Signed in another state

An advance health care directive signed in another state in compliance with that state's law or Alabama law is valid in Alabama, but it cannot authorize care that Alabama law prohibits.

Law: Ala. Code § 22-8A-12; § 26-1A-404(c)(13) for health care powers of attorney

Registry

Recording a living will with the judge of probate in your county

Fee: $5, plus any other recording fees set by law

Law: Ala. Code § 22-8A-14(b)

POLST (medical orders)

Portable Physician DNAR (Do Not Attempt Resuscitation) Order, on the form designated by the State Board of Health

Law: Ala. Code § 22-8A-14; Ala. Code § 22-8A-3(16)

Free notice: revoke or change a health care directive

Names and addresses of people and facilities that should know. They go into your letter only.

Other formats

Sign the letter and keep a copy. This tool does not check whether your document is valid, and it is not legal advice.

Free help in Alabama

Report abuse or exploitation

Alabama Department of Human Resources, Adult Protective Services · 1-800-458-7214

Questions about powers of attorney in Alabama

How do I sign a health care directive in Alabama?

Put the directive in writing, date it, and sign it in front of two qualified witnesses who are at least 19. If you name a health care proxy, the proxy must accept in writing, and the acceptance is attached to the directive.

Who decides my health care if I have no directive in Alabama?

If there is no directive or no available proxy, a surrogate can decide about life-sustaining treatment and tube feeding, in consultation with the attending physician, but only if two physicians certify a terminal illness or injury or permanent unconsciousness and the other conditions in the law are met.

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