Health care directive in Washington: form, signing and who decides
The form, who can witness, who can be your agent and who decides if you have no directive in Washington.
Checked against official sources: October 31, 2026.
Short answer
Durable power of attorney for health care (and a separate health care directive under the Natural Death Act)
- Official form
- 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
- Durable power of attorney for health care (and a separate health care directive under the Natural Death Act)
- Official form
- Health Care Directive (suggested form in RCW 70.122.030)Published by Washington State LegislatureVersion: Statutory text as amended by Laws of 2025, ch. 56 (pregnancy clause removed)
You do not have to use it.
- Living will
Health Care Directive
The living will is a separate document.
A health care directive says whether you want life-sustaining treatment withheld or withdrawn if you are in a terminal condition or a permanent unconscious condition, and whether you want artificially provided nutrition and hydration. It is separate from the durable power of attorney for health care. You can add other specific directions.
Law: RCW 70.122.030
Signing rules
- How to sign
Each document is signed and then either acknowledged before a notary public or signed in front of two qualified witnesses. The witness rules for the health care directive and for the durable power of attorney for health care are different.
- Who signs
Health care directive: signed by you (the declarer). Durable power of attorney for health care: signed and dated by you, as for any power of attorney.
- Notary
- A notary or witnesses (your choice)
- Witnesses
- 2 (instead of a notary)
- Who cannot witness
Health care directive witnesses cannot be related to you by blood or marriage, cannot be people who would inherit from you under your will or by law, cannot have a claim against your estate, and cannot be your attending physician, the physician's employee, or an employee of a health facility where you are a patient. Durable power of attorney witnesses cannot be related to you or your agent by blood, marriage or registered domestic partnership, and cannot be your home care provider or a care provider at an adult family home or long-term care facility where you live.
- Nursing facilities and special settings
For a power of attorney, a care provider at an adult family home or long-term care facility where you live cannot be a witness.
Law: RCW 11.125.050
Law: RCW 70.122.030(1); RCW 11.125.050
Who can be your agent and what the agent can do
- Who cannot be your agent
Your physicians, their employees, and the owners, administrators or employees of a health care facility or long-term care facility where you live or get care cannot be your health care agent unless they are your spouse, state registered domestic partner, parent, adult child, brother or sister.
Law: RCW 11.125.400(3)
- When the agent starts
A durable power of attorney for health care takes effect when signed unless it says it starts later, for example on incapacity. If it starts on incapacity and no one you named makes the decision, a physician or licensed psychologist who examined you and is unrelated to you or the agent can determine incapacity in writing. Health care authority must be expressly granted in the power of attorney.
Law: RCW 11.125.090; RCW 11.125.240(1)(l)
- Decisions an agent cannot make
A health care agent's authority has the same limits as a guardian's: for example, without a court order the agent cannot consent to electroconvulsive therapy, psychosurgery or other psychiatric procedures restricting freedom of movement, unless you consented in a mental health advance directive. No rights under the Death with Dignity Act can be exercised through an agent.
Law: RCW 11.125.400(3), 11.130.335; RCW 11.125.420
Revoking and conflicting documents
- Revoking your agent
You revoke a durable power of attorney for health care in the same way as any power of attorney; an agent's authority also ends when a divorce, annulment or legal separation action is filed between you and a spouse or registered domestic partner agent, unless the document says otherwise.
Law: RCW 11.125.100
- Revoking your instructions
You can revoke a health care directive at any time, whatever your mental state, by destroying it (or having someone destroy it in your presence at your direction), by a signed and dated written revocation, or by telling someone verbally. A written or verbal revocation takes effect when it is communicated to your attending physician.
Law: RCW 70.122.040
- Telling others
Tell your attending physician. The physician must record the revocation in your medical record.
- Divorce ends a spouse's authority
- Yes · Divorce rules in Washington (Divorce Law Map)
Law: RCW 70.122.040; RCW 11.125.100
If you have no directive
- Who decides without a directive
This is a priority list. A provider goes to the next group only if no one in a higher group is reasonably available. No one can consent if a person in a higher group refused, or if people in the same group do not all agree. The decision-maker must first decide what you would want; if that cannot be known, they decide in your best interest.
- Your guardian, if any
- Your agent under a durable power of attorney that covers health care
- Your spouse or state registered domestic partner
- Your adult children
- Your parents
- Your adult brothers and sisters
- Your adult grandchildren who are familiar with you
- Your adult nieces and nephews who are familiar with you
- Your adult aunts and uncles who are familiar with you
- A close adult friend who signs a declaration under penalty of perjury (not your doctor, a facility owner or employee, or a paid caregiver)
Law: RCW 7.70.065(1)
Other states, registry and medical orders
- Signed in another state
A health care directive made in another state is valid to the extent Washington law and federal constitutional law allow. A power of attorney (including one for health care) signed in another state is valid if signed under the law it names or where it was signed.
Law: RCW 70.122.030(3); RCW 11.125.060
- POLST (medical orders)
Portable Orders for Life Sustaining Treatment (POLST)
- Mental health directive
You can make a mental health advance directive under chapter 71.32 RCW. It must be in writing, dated and signed, and either notarized or witnessed in writing by at least two adults who know you and were present when you signed. If it names an agent, it must include words showing the agent's authority continues if you become incapacitated.
Law: RCW 71.32.060
Law: RCW 70.122.130; RCW 43.70.480
Free notice: revoke or change a health care directive
Free help in Washington
- CLEAR legal aid hotline (Northwest Justice Project), listed on the Washington Courts forms pages · 1-888-201-1014
- Washington Law Help (Northwest Justice Project)
- Washington Courts: Guardianship, conservatorship and protective arrangement forms
- Washington Law Help: Powers of attorney and advance directives (forms and instructions)
- Washington Law Help: Durable power of attorney (finances and health care forms)
- Washington Law Help: Cancel (revoke) a power of attorney
Report abuse or exploitation
Adult Protective Services (DSHS Aging and Long-Term Support Administration)
Questions about powers of attorney in Washington
How do I sign a health care directive in Washington?
Each document is signed and then either acknowledged before a notary public or signed in front of two qualified witnesses. The witness rules for the health care directive and for the durable power of attorney for health care are different.
Who decides my health care if I have no directive in Washington?
This is a priority list. A provider goes to the next group only if no one in a higher group is reasonably available. No one can consent if a person in a higher group refused, or if people in the same group do not all agree.