eForms Logo

Rhode Island Advance Directive Form

5.0 Stars | 9 Ratings
Downloads: 107

Updated August 18, 2025

A Rhode Island advance directive is a form used to record a person's medical treatment preferences and select an agent to speak on their behalf if they cannot do so for themselves. The form is a combination of a medical power of attorney and a living will.

Versions (6)

AARP

Download: PDF

 

 

 

Catholic Church

Download: PDF

 

 

 

Dept. of Health

Download: PDF

 

 

 

Hope Health

Download: PDF

 

 

 

Providence Health Care

Download: PDF

 

 

 

Spanish (Español) Version

Download: PDF

 

 

 

Registration

Rhode Island does not have an advance directive registry. After creating their advance directive, the declarant should provide copies to their physician, their family, and their health care representative.

Revocation

An advance directive may be revoked at any time and in any manner that communicates the declarant’s intent to revoke, without regard to mental or physical condition.[2]

State Definition

Rhode Island law refers to advance directives as “declarations”.
“Declaration” means a witnessed document executed in accordance with the requirements of § 23-4.11-3 or § 23-4.11-3.1.[3]

Statutory Form

An optional advance directive form is available under Rhode Island state law.[4]

Sample

Download: PDF

Sources

  1. R.I. Gen. Laws § 23-4.11-3(a)
  2. R.I. Gen. Laws § 23-4.11-4(a)(1)
  3. R.I. Gen. Laws § 23-4.11-2(4)
  4. R.I. Gen. Laws § 23-4.11-3(d)