Health care directive in Connecticut: form, signing and who decides
The form, who can witness, who can be your agent and who decides if you have no directive in Connecticut.
Checked against official sources: October 31, 2026.
Short answer
Appointment of health care representative (can be combined with a living will)
- How to sign
- Signed in front of two witnesses (no notary)
- Who decides without a directive
- No
The document and its form
- Document
- Appointment of health care representative (can be combined with a living will)
- Official form
- Health care instructions, appointment of health care representative, designation of conservator and anatomical gift - combined form (Conn. Gen. Stat. 19a-575a)Published by Connecticut Office of the Attorney GeneralVersion: Attorney General combined form, file dated 2006 ('advdirectivescombinedform2006alt'); the statutory form text was later amended (pregnancy instructions 2018, APRN references 2018, technical change 2019)
You do not have to use it.
- Living will
Living will (document concerning health care and withholding or withdrawal of life support systems)
Part of the directive.
You can write health care instructions, including about life support, either in a separate living will or in the combined document with your health care representative. A living will must be signed and dated with at least two witnesses.
Law: Conn. Gen. Stat. 19a-575a, 19a-577; Conn. Gen. Stat. 19a-575, 19a-575a
Signing rules
- How to sign
Sign and date the document in front of two adult witnesses, who also sign. Your health care representative cannot be a witness. Notarization is not required; the witnesses may optionally sign a sworn affidavit, which makes the document easier to prove.
- Who signs
Signed and dated by you.
- Notary
- Not required
- Witnesses
- 2
- Who cannot witness
Two adult witnesses must sign. The person you appoint as health care representative cannot be a witness.
- Nursing facilities and special settings
If you live in a facility operated or licensed by the Department of Mental Health and Addiction Services, at least one witness must not be affiliated with the facility and at least one must be a physician, APRN or licensed clinical psychologist with specialized training in treating mental illness. If you live in a facility operated or licensed by the Department of Developmental Services, the same applies with training in developmental disabilities.
Law: Conn. Gen. Stat. 19a-575, 19a-575a, 19a-576, 19a-578
Who can be your agent and what the agent can do
- Who cannot be your agent
If you are a patient or resident of, or have applied to, a hospital, residential care home, rest home with nursing supervision or chronic and convalescent nursing home, you cannot appoint its operator, administrator or employee, and you cannot appoint an administrator or employee of a government agency financially responsible for your care, unless the person is related to you by blood, marriage or adoption. A physician or APRN cannot be both your health care representative and your attending physician or APRN.
Law: Conn. Gen. Stat. 19a-576
- When the agent starts
A living will or appointment of health care representative becomes operative when it is given to your attending physician or APRN and they determine that you are incapacitated. The representative can ask for that determination in writing.
Law: Conn. Gen. Stat. 19a-579
- Decisions an agent cannot make
The statutory forms let the representative make health care decisions, including about life support, except as otherwise provided by law, such as for psychosurgery or shock therapy. Unless a court orders otherwise, a health care representative's decisions take precedence over a conservator's, with exceptions for certain psychiatric and criminal-court commitments.
Law: Conn. Gen. Stat. 19a-575a, 19a-577; Conn. Gen. Stat. 19a-580e
Revoking and conflicting documents
- Revoking your agent
An appointment of a health care representative can be revoked only by you, in a writing signed by you and two witnesses. Revoking the appointment does not by itself revoke your living will.
Law: Conn. Gen. Stat. 19a-575a(b)
- Revoking your instructions
You can revoke a living will at any time and in any manner, whatever your mental or physical condition.
Law: Conn. Gen. Stat. 19a-579a
- Telling others
Your attending physician or other provider must put the revocation in your medical record. A person who acts on the document without knowing of the revocation is protected.
Law: Conn. Gen. Stat. 19a-575a, 19a-579a
- Divorce ends a spouse's authority
- Yes · Divorce rules in Connecticut (Divorce Law Map)
Law: Conn. Gen. Stat. 19a-575a, 19a-579a, 19a-579b
If you have no directive
- Who decides without a directive
Connecticut has no general statutory list of who decides for you if you have no health care representative. Before removing or withholding life support, the attending physician or APRN must consider your wishes, including by consulting your health care representative, next of kin, legal guardian or conservator, a person you designated under section 1-56r, and others you told your wishes to.
Law: Conn. Gen. Stat. 19a-571, 19a-580
Law: Conn. Gen. Stat. 19a-571, 19a-580
Other states, registry and medical orders
- Signed in another state
Health care instructions or a health care proxy signed under another state's (or a foreign country's) law, or under Connecticut law, are valid if not contrary to Connecticut public policy. A provider may rely on a court order, a notarized statement that the document is valid where made, or its own good-faith legal analysis.
Law: Conn. Gen. Stat. 19a-580g
- POLST (medical orders)
Medical Order for Life-Sustaining Treatment (MOLST)
Law: Conn. Gen. Stat. 19a-580h
Free notice: revoke or change a health care directive
Free help in Connecticut
- Statewide Legal Services of Connecticut (legal aid hotline) · 1-800-453-3320
- CTLawHelp.org
- Connecticut Probate Courts: Conservatorship
- Probate Court User Guide for Conservators (PDF)
- Connecticut Attorney General: Connecticut's Living Will Laws (forms)
Report abuse or exploitation
Connecticut Department of Social Services - Protective Services for the Elderly · 1-888-385-4225
Questions about powers of attorney in Connecticut
How do I sign a health care directive in Connecticut?
Sign and date the document in front of two adult witnesses, who also sign. Your health care representative cannot be a witness. Notarization is not required; the witnesses may optionally sign a sworn affidavit, which makes the document easier to prove.
Who decides my health care if I have no directive in Connecticut?
Connecticut has no general statutory list of who decides for you if you have no health care representative. Before removing or withholding life support, the attending physician or APRN must consider your wishes, including by consulting your health care representative, next of kin, legal guardian or conservator, a person you designated under section 1-56r, and others you told your wishes to.