Health care directive in Virginia: form, signing and who decides
The form, who can witness, who can be your agent and who decides if you have no directive in Virginia.
Checked against official sources: October 31, 2026.
Short answer
Advance Directive (Advance Medical Directive)
- Official form
- Advance Medical Directive
- 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 (Advance Medical Directive)
- Official form
- Advance Medical Directive (suggested form, Va. Code 54.1-2984)Published by Virginia General Assembly, Code of VirginiaVersion: Statutory text as last amended in 2015 (2015, c. 109)
You do not have to use it.
- Living will
Health care instructions in the advance directive (Option III: life-prolonging procedures)
Part of the directive.
Virginia uses one advance directive for both naming an agent and writing treatment wishes, including whether you want life-prolonging procedures if you have a terminal condition. You can fill in only the parts you want.
Law: Va. Code § 54.1-2984; Va. Code §§ 54.1-2983, 54.1-2984
Signing rules
- How to sign
Sign the advance directive in front of two adult witnesses, who sign it too. No notary is required. If your doctor has diagnosed a terminal condition, you can also make an oral advance directive in front of your attending physician and two witnesses.
- Who signs
Signed by you (the declarant), with the date.
- Notary
- Not required
- Witnesses
- 2
- Who cannot witness
Two witnesses who are 18 or older must see you sign. A spouse or blood relative can be a witness. Employees of health care facilities and doctors' offices acting in good faith can also be witnesses.
Law: Va. Code §§ 54.1-2982, 54.1-2983
Who can be your agent and what the agent can do
- Who cannot be your agent
Any adult.
Law: Va. Code 54.1-2982 'Agent'
- When the agent starts
The agent can decide only after your attending physician certifies in writing, after examining you, that you cannot make an informed decision, and a capacity reviewer also certifies it (not needed if you are unconscious or profoundly impaired after trauma or stroke). The certification is repeated at least every 180 days while care continues. One physician can find in writing that you have regained capacity.
Law: Va. Code 54.1-2983.2
- Decisions an agent cannot make
The Act cannot be used to authorize nontherapeutic sterilization, abortion or psychosurgery. An agent can consent to admission to a mental health facility only if your directive expressly allows it. An agent can restrict your visitors only if your directive expressly covers visitation. The agent cannot override your wishes on organ donation.
Law: Va. Code 54.1-2983.2(C), 54.1-2983.3, 54.1-2986.1
Revoking and conflicting documents
- Revoking your agent
You can revoke the whole directive or part of it, including the naming of your agent, at any time: by a signed, dated writing, by destroying or cancelling it (or having someone do so in your presence at your direction), or by saying you revoke it. The revocation takes effect when it is communicated to your attending physician.
- Revoking your instructions
The same methods apply to your treatment instructions; any parts you do not revoke stay in effect.
- Telling others
If the directive is in the Advance Health Care Planning Registry, the revocation must be notarized before it is sent to the Department of Health for removal; not doing so does not undo a valid revocation.
Law: Va. Code 54.1-2985(B)
- Divorce ends a spouse's authority
- Yes · Divorce rules in Virginia (Divorce Law Map)
Law: Va. Code § 54.1-2985
If you have no directive
- Who decides without a directive
If you cannot make an informed decision and have no directive covering the decision and no agent, your doctor may rely on the first available, willing and capable person in this order. If people in the same class disagree, the doctor may follow a majority of those reasonably available.
- A guardian
- Your spouse (unless a divorce action is filed and not final)
- An adult child
- A parent
- An adult brother or sister
- Other relatives in descending order of blood relationship
- An adult close to you who has shown special care and concern and knows your values (not for withholding or withdrawing life-prolonging procedures; not a provider's staff)
Law: Va. Code § 54.1-2986
Other states, registry and medical orders
- Signed in another state
An advance directive signed in another state is valid in Virginia if it follows Virginia law or the law of the state where it was signed; it is read under Virginia law.
Law: Va. Code 54.1-2993
- Registry
Fee: Any fee is set by the contracted operator and may not exceed direct costs; no fee to file a revocation (12VAC5-67; Va. Code 54.1-2995).
- POLST (medical orders)
Durable Do Not Resuscitate Order (DDNR); the registry also accepts 'portable medical order' forms
- Mental health directive
Your advance directive can cover mental health treatment and can let your agent consent to admission to a mental health facility if it expressly says so; then a broader list of professionals can determine incapacity for that admission.
Law: Va. Code 54.1-2983.2(C)
Law: Va. Code §§ 54.1-2994, 54.1-2995, 54.1-2996; Va. Code §§ 54.1-2987.1, 54.1-2995
Free notice: revoke or change a health care directive
Free help in Virginia
- Virginia Law Help (statewide legal aid website)
- Virginia Department of Health: Advance Health Care Directive Registry
- Code of Virginia: suggested advance directive form (54.1-2984)
- Virginia courts: guardianship/conservatorship cover sheet CC-1640
Report abuse or exploitation
Adult Protective Services (Virginia Department for Aging and Rehabilitative Services; local departments of social services) · (888) 832-3858
Questions about powers of attorney in Virginia
How do I sign a health care directive in Virginia?
Sign the advance directive in front of two adult witnesses, who sign it too. No notary is required. If your doctor has diagnosed a terminal condition, you can also make an oral advance directive in front of your attending physician and two witnesses.
Who decides my health care if I have no directive in Virginia?
If you cannot make an informed decision and have no directive covering the decision and no agent, your doctor may rely on the first available, willing and capable person in this order. If people in the same class disagree, the doctor may follow a majority of those reasonably available.