Getting a health care proxy requires just a few steps: choosing someone you trust, filling out a legal form specific to your state, and signing it in front of witnesses or a notary. The entire process can be done at home, without a lawyer, and usually takes less than an hour. Here’s how to do it right.
What a Health Care Proxy Actually Is
A health care proxy is a person you name to make medical decisions on your behalf if you become unable to communicate them yourself. The legal document that names this person is called a durable power of attorney for health care, though the terminology varies by state. Some states call the person your “health care agent,” “surrogate,” or “representative.” Regardless of the label, the function is the same: this person speaks for you when you can’t speak for yourself.
A health care proxy is not the same as a living will, though the two work together. A living will spells out your specific wishes for medical treatment, such as whether you want to be kept on life support. A health care proxy gives a real person the authority to interpret those wishes and make judgment calls in situations you didn’t anticipate. Many experts recommend that if you only do one, naming a proxy should be the priority, because no written document can cover every possible medical scenario. If you create both, share your living will with your proxy so they understand your values and preferences clearly.
How to Choose the Right Person
Your proxy doesn’t need to be a lawyer or a medical professional. They need to be someone who understands your values, can stay calm under pressure, and is willing to advocate for what you want even when family members or doctors might push back. This is often a spouse or adult child, but it can also be a close friend, sibling, or anyone you trust deeply.
A few practical considerations matter here. Your proxy should live close enough (or be reachable enough) to respond quickly in an emergency. They should be comfortable talking about difficult topics like end-of-life care, pain management, and resuscitation. And they should be someone who will follow your wishes rather than substitute their own. Have a direct conversation with them before you fill out any paperwork. Tell them what matters to you: whether you’d want aggressive treatment to extend your life, how you feel about feeding tubes or ventilators, and what quality of life means to you. You can’t anticipate every medical situation, so make sure you feel comfortable allowing your proxy to make decisions about matters you haven’t specifically discussed.
Most states also let you name an alternate proxy in case your first choice is unavailable when the time comes.
Get Your State’s Form
Every state has its own health care proxy form with its own specific requirements. Using the correct form for your state matters, because a document that doesn’t meet your state’s legal standards may not be honored by a hospital.
You can download your state’s form for free from CaringInfo (caringinfo.org), a program of the National Alliance for Care at Home. The site provides advance directive forms and instructions for all 50 states and U.S. territories in PDF format. Your state’s department of health or attorney general’s office is another reliable source. Many hospitals and senior centers also keep blank forms on hand.
You do not need a lawyer to complete the form. The documents are designed for regular people to fill out on their own. That said, if your situation is complex (for example, you have assets in multiple states or a blended family with potential disagreements), consulting an attorney can be worthwhile.
Fill Out and Sign the Form
The form itself is straightforward. You’ll write in your name, your proxy’s name and contact information, and optionally your alternate proxy’s details. Some forms include space where you can note specific instructions or limitations on what your proxy can decide.
The signing requirements vary by state, but most states require one of two things: either two adult witnesses who watch you sign and then sign the document themselves, or a notary public who stamps and signs it. Some states require both. In states that use witnesses, there are restrictions on who can serve as one. In New Jersey, for example, the person you’re appointing as your proxy cannot also be a witness. Some states also bar your health care providers or their employees from witnessing. Check your state’s specific instructions, which are typically included with the downloadable form.
You do not need to file the form with a court or government agency for it to be valid. Once properly signed and witnessed (or notarized), it’s a legally binding document.
Store It Where It Can Be Found
A health care proxy that no one can locate in an emergency is useless. Give signed copies to your proxy, your alternate proxy, and your primary care doctor. Ask your doctor’s office to add it to your medical record. If your health system uses a patient portal like MyChart, you can often upload the document directly so it’s accessible to any provider within that system.
Keep the original in a place that’s easy to find, like a home filing cabinet or a fireproof safe that someone else knows how to access. Don’t put it in a bank safe deposit box, since those can be difficult to open quickly. Some states maintain electronic advance directive registries where you can store the document digitally, but availability varies.
Also tell your close family members and friends that the document exists and who your proxy is. In an emergency room situation, doctors need to know quickly whether a proxy has been named and how to reach that person.
When the Proxy’s Authority Kicks In
Your health care proxy has no authority over your medical decisions while you’re able to make them yourself. The proxy’s power activates only when your attending physician formally determines that you lack the capacity to make or communicate your own decisions. This requires a clinical assessment of your mental state, and the determination must be documented in writing with specific reasons noted in your medical record.
If you regain capacity, the proxy’s authority stops. This isn’t a permanent transfer of power. It’s a safety net that activates and deactivates based on your ability to participate in your own care. Common scenarios where a proxy would step in include being unconscious after an accident, being under heavy sedation during surgery complications, or experiencing advanced dementia.
How to Update or Revoke It
You can change or cancel your health care proxy at any time, as long as you have the mental capacity to do so. If you want to revoke the document entirely, most states allow you to do this in writing or by verbally informing your health care provider, who will then document it in your record. Some states let you revoke treatment instructions by any action that clearly communicates your intent, such as tearing up the document.
If you want to name a new proxy rather than simply canceling the old one, the cleanest approach is to complete a brand-new form. A previously valid advance directive remains in effect until you officially rescind it, so don’t assume that creating a new document automatically voids the old one. Notify your former proxy, your new proxy, and your doctors about the change. Collect and destroy old copies when possible to avoid confusion.
Review your proxy designation after major life changes: a divorce, a move to a new state, the death of your named proxy, or a shift in your health care preferences. There’s no expiration date on most health care proxy forms, but circumstances change, and a document from 20 years ago may no longer reflect your wishes or your relationships.