Health care directive in California: form, signing and who decides
The form, who can witness, who can be your agent and who decides if you have no directive in California.
Checked against official sources: October 31, 2026.
Short answer
Advance Health Care Directive
- Official form
- Advance Health Care Directive
- How to sign
- Notarized or signed by two adult witnesses
- Who decides without a directive
- Yes
The document and its form
- Document
- Advance Health Care Directive
- Official form
- Advance Health Care Directive (Probate Code 4701)Published by California Office of the Attorney GeneralVersion: Fillable PDF dated September 2022
You do not have to use it.
- Living will
Instructions for Health Care (Part 2 of the Advance Health Care Directive)
Part of the directive.
California does not use a separate living will form. You write your treatment wishes, such as about life support and pain relief, in Part 2 of the advance health care directive. You can fill in Part 2 even if you do not name an agent. Individual instructions can also be oral.
Law: Cal. Prob. Code §§ 4700, 4701; Cal. Prob. Code §§ 4670, 4701
Signing rules
- How to sign
Sign and date the directive. Then either have it notarized or have two qualified adult witnesses sign it. In a skilled nursing facility, an ombudsman or patient advocate must also witness it.
- Who signs
Signed by you, or in your name by another adult in your presence and at your direction, and dated.
- Notary
- A notary or witnesses (your choice)
- Witnesses
- 2 (instead of a notary)
- Who cannot witness
Witnesses must be adults who see you sign or acknowledge the directive, and must sign a declaration. These people cannot be witnesses: your health care provider or their employee, the operator or an employee of a community care facility or residential care facility for the elderly, and your health care agent. At least one witness must not be related to you by blood, marriage or adoption and must not inherit from you.
- Nursing facilities and special settings
If you live in a skilled nursing facility when you sign, a patient advocate or ombudsman must also sign as a witness (as one of the two witnesses or in addition to a notary).
- Electronic signing
An electronic advance health care directive must be acknowledged before a notary public, and a digital signature must meet the rules in Probate Code 4673(b).
Law: Cal. Prob. Code §§ 4673, 4674, 4675
Who can be your agent and what the agent can do
- Who cannot be your agent
Your supervising health care provider, an employee of the health care institution where you receive care, and an operator or employee of a community care or residential care facility where you receive care cannot be your agent, unless they are related to you (by blood, marriage, adoption or registered domestic partnership) or are a coworker (an employee other than your supervising provider). A mental health (LPS) conservator can be named only if you have a lawyer who signs a certificate on the directive.
Law: Prob. Code 4659
- When the agent starts
Unless the directive says otherwise, the agent's authority starts only when your primary physician determines that you lack capacity, and stops when you recover capacity. You can choose to let the agent act right away.
Law: Prob. Code 4658, 4682
- Decisions an agent cannot make
An agent cannot consent for you to placement in a mental health treatment facility, convulsive treatment, psychosurgery, sterilization or abortion. An agent cannot make a decision you object to.
Law: Prob. Code 4652; Prob. Code 4689
Revoking and conflicting documents
- Revoking your agent
You can revoke your choice of agent only by a signed writing or by personally telling your supervising health care provider.
- Revoking your instructions
You can revoke the rest of the directive at any time and in any way that shows you want to revoke it.
- Telling others
A provider, agent, conservator or surrogate who learns of the revocation must promptly tell your supervising health care provider and any health care institution where you are receiving care.
- Divorce ends a spouse's authority
- Yes · Divorce rules in California (Divorce Law Map)
- Conflicting documents
A newer advance health care directive revokes an older one to the extent they conflict.
Law: Prob. Code 4698
Law: Cal. Prob. Code §§ 4695, 4696, 4697
If you have no directive
- Who decides without a directive
If you lack capacity and have none of these, a health care provider or facility designee may choose an adult surrogate who has shown special care and concern for you and knows your values. The surrogate can be chosen from your spouse or domestic partner, an adult child, a parent, an adult sibling, an adult grandchild, or an adult relative or close personal friend. You can disqualify someone from acting as your surrogate by a signed writing or by telling your supervising health care provider.
- A surrogate you named by telling your supervising health care provider
- Your agent under an advance health care directive or power of attorney for health care
- Your conservator or guardian with health care authority
Law: Cal. Prob. Code §§ 4711, 4712, 4715
Other states, registry and medical orders
- Signed in another state
An advance directive signed in another state under that state's law, or under California law, is valid in California.
Law: Prob. Code 4676
- Registry
Advance Health Care Directive Registry (California Secretary of State)
Fee: $10 to register a directive, including a new or amended directive. No fee to change the information on your registration or to revoke the registration. Registration is by mail only, on the Registration of Written Advance Health Care Directive form.
- POLST (medical orders)
Physician Orders for Life Sustaining Treatment (POLST), approved by the Emergency Medical Services Authority
- Mental health directive
You can make a standalone psychiatric advance directive that records your mental health treatment preferences. It must follow the same signing rules as an advance health care directive.
Law: Prob. Code 4679
Law: Cal. Prob. Code §§ 4800-4805; Cal. Prob. Code § 4780
Free notice: revoke or change a health care directive
Free help in California
- Court self-help centers and other free legal resources (California Courts list)
- Legal services for people 60 and older through local Area Agencies on Aging (California Department of Aging)
- California Courts Self-Help: Helping a person with an impairment or disability
- California Courts Self-Help: Options to help someone (supported decision-making, power of attorney, directive)
- California Attorney General: Advance health care directives
- Find free legal aid at LawHelp.org
Report abuse or exploitation
County Adult Protective Services (California Department of Social Services) · 1-833-401-0832
Questions about powers of attorney in California
How do I sign a health care directive in California?
Sign and date the directive. Then either have it notarized or have two qualified adult witnesses sign it. In a skilled nursing facility, an ombudsman or patient advocate must also witness it.
Who decides my health care if I have no directive in California?
If you lack capacity and have none of these, a health care provider or facility designee may choose an adult surrogate who has shown special care and concern for you and knows your values. The surrogate can be chosen from your spouse or domestic partner, an adult child, a parent, an adult sibling, an adult grandchild, or an adult relative or close personal friend.