You can get a health care proxy form for free from your state’s department of health website, your doctor’s office, or a hospital admissions desk. The form is typically one to two pages long, and most people can complete it in under 15 minutes without a lawyer.
Where to Find Your State’s Form
Every state has its own version of this form, and the terminology varies. Some states call it a “health care proxy,” others use “durable power of attorney for health care” or “advance health care directive.” Regardless of the name, the purpose is the same: you’re designating someone to make medical decisions for you if you become unable to make them yourself.
The most reliable free sources for your state’s form include:
- Your state’s department of health or attorney general website. Search your state name plus “health care proxy form” or “advance directive form.” Many states host a downloadable PDF.
- Your doctor’s office or hospital. Federal law (the Patient Self-Determination Act) requires hospitals participating in Medicare and Medicaid to inform all adult patients of their right to create advance directives. Most keep blank forms on hand and will give you one if you ask.
- Nonprofit organizations. Groups like the National Hospice and Palliative Care Organization (NHPCO) and AARP offer free, state-specific forms online.
You do not need an attorney to fill out the form, though consulting one is an option if your situation is complex, such as blended families or significant assets tied to care decisions.
What a Health Care Proxy Actually Does
A health care proxy names a specific person (your “agent”) to speak for you when you cannot speak for yourself. It does not go into effect while you’re able to communicate your own wishes. A physician must first certify that you can no longer make your own health care decisions before your agent gains any authority.
This is different from a living will. A living will spells out specific treatments you do or don’t want, but it doesn’t name anyone to advocate for you. A health care proxy gives a real person the flexibility to respond to situations you may not have anticipated. Many people complete both documents, and a living will can serve as a guide for the agent you’ve named in your proxy.
How to Fill Out the Form
The form itself asks for basic information: your name, the name and contact information of your chosen agent, and often space to name an alternate agent in case your first choice is unavailable. Some state forms also include a section where you can write specific instructions or limitations on your agent’s authority.
Read the directions on your state’s form carefully, because signing requirements differ. Some states require two adult witnesses to watch you sign. Others require notarization. A few require both. In many states, your agent cannot serve as one of your witnesses, and some states prohibit your doctor or employees of your health care facility from witnessing. Getting the signing wrong can make the document unenforceable, so this is the one step worth double-checking.
Choosing the Right Agent
The person you name matters more than the form itself. Your agent should be someone who understands your values around medical care, can handle stressful conversations with doctors, and is willing to follow your wishes even if they personally disagree. This is often a spouse, adult child, or close friend, but it doesn’t have to be a family member.
Before you finalize the form, have a direct conversation with the person you’re naming. Make sure they’re willing to take on the responsibility. Tell them what matters to you: whether you’d want aggressive treatment in a terminal situation, how you feel about mechanical ventilation or feeding tubes, and what quality of life means to you. The more specific you are in this conversation, the easier their job becomes if they ever need to act on your behalf.
What to Do After You Sign It
A completed health care proxy sitting in a desk drawer won’t help anyone in an emergency. Give copies to your agent and your alternate agent. Give a copy to your primary care doctor so it can be added to your medical record. If you have an attorney, provide a copy there as well. Florida’s health care administration recommends also making sure “the significant persons in your life know that you have an advance directive and where it is located.”
Keep the original in a place that’s easy to find, not a safe deposit box that nobody can access on a weekend. Some people keep a wallet card noting that they have a health care proxy and where the document is stored.
If your circumstances change (a divorce, a falling out with your agent, or simply a change of heart), you can revoke and replace the form at any time. Just make sure everyone who has a copy of the old version gets the updated one.
Using a Health Care Proxy Across State Lines
If you spend time in more than one state, be aware that each state has its own rules. Most states will honor an out-of-state directive as long as it meets the basic legal requirements, but this isn’t guaranteed. The National Institute on Aging recommends completing the form specific to your state. If you split your time between two states, completing a valid form for each one is the safest approach. The forms are free and short enough that having two is a minor effort for significant peace of mind.