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Arizona Advance Directive Form

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Arizona Advance Directive Form

Updated February 27, 2024

An Arizona advance directive lets an individual select a healthcare agent to make decisions on their behalf and make end-of-life treatment selections. The agent selected should be a spouse, family member, or close friend. The agent will have the right to make any medical decision aligned with the person’s wishes.

Signing Requirements

A principal must sign with one witness or a notary public.[1] A notary or witness cannot be any of the following:

  • The agent mentioned in the advance directive;
  • A person directly involved with providing health care to the principal;
  • A person related to the principal by blood, marriage, or adoption;[2] and
  • A person entitled to any part of the principal’s estate.[3]

Versions (3)

  1. Attorney General
  2. Northern Arizona Healthcare
  3. Spanish (Español) Version
Arizona Attorney General

Download: PDF

Northern Arizona Healthcare

Download: PDF

Spanish Version (Español)

Download: PDF

Registration

There are no requirements to register, but a principal can do so if they choose with the Arizona Healthcare Directives Registry.[4]

Revocation

An advance directive can be terminated by:

  • Making a written revocation form;
  • Orally notifying the agent or health care provider;
  • Making a new health care directive; or
  • Any other act that shows an intent to revoke or disqualify an agent.[5]

State Definition

A health care directive means a document drafted in substantial compliance with this chapter, including a mental health care power of attorney, to deal with a person’s future health care decisions.[6]

Statutory Form

There is no statutory form as an advanced directive combines a medical power of attorney and living will.

Sources

  1. ARS § 36-3221(A)(3)
  2. ARS § 36-3221(C)
  3. ARS § 36-3221(D)
  4. www.azhha.org/tlc_forms
  5. ARS § 36-3202
  6. ARS § 36-3201(5)