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Louisiana Advance Directive Form

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Updated August 05, 2025

A Louisiana advance directive is a document that lets a person choose a medical agent to handle health care decisions on their behalf in case they become unable to speak or make decisions for themselves. The agent must operate under the instructions of the advance directive and adhere to the requests made by the declarant.

Versions (6)

AARP

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Louisiana.Gov

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Mark Zinder Version

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Ochsner Health

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Our Lady of the Lake

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Spanish (Español) Version

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Registration

A resident of Louisiana may register their advance directive by submitting a copy and a check for $20 payable to the ‘Louisiana Secretary of State’ and send to:

Louisiana Secretary of State
Elections Services
P.O. Box 94125
Baton Rouge, LA 70804-9125

Attach an additional $20 if a certified copy is requested.[2]

Revocation

An advance directive can be revoked by the declarant at any time, regardless of their mental state or competency, via a written revocation, an oral expression of their intent to revoke, or the physical destruction of the form by the declarant.[3]

State Definition

A Louisiana advance directive is otherwise referred to as a “declaration.”
“Declaration” means a witnessed document, statement, or expression voluntarily made by the declarant, authorizing the withholding or withdrawal of life-sustaining procedures, in accordance with the requirements of this Subpart. A declaration may be made in writing, orally, or by other means of nonverbal communication.[4]

Statutory Form

A statutory form of an advance directive is available under Louisiana law, but its use is not required for an advance directive to be valid.[5]

Sample

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