California Advance Directive Form

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Updated April 14, 2023

A California advance health care directive allows an individual to choose an agent to make medical decisions on their behalf and select end-of-life treatment options. An advance directive combines a medical power of attorney and a living will. It is recommended to be completed by elderly individuals and those seeking high-risk medical procedures.

The main purpose is to allow loved ones to make medical decisions on a person’s behalf and to outline their preferred life-saving treatment options. It is a combination of a medical power of attorney and a living will.

Advance Directive Includes

  • Part 1. Power of Attorney for Health Care
  • Part 2. Instructions for Health Care
  • Part 3. Donation of Organs, Tissues, and Parts at Death
  • Part 4. Primary Physician
  • Part 5. Signature
  • Part 6. Special Witness Requirement

Table of Contents

Laws

Statute – PROB § 4701

Signing Requirements (PROB § 4701) – Two (2) witnesses or a notary public.

State Definition (PROB § 4605) – “Advance health care directive” or “advance directive” means either an individual health care instruction or a power of attorney for health care.”

Registering

An individual can register an advance directive by completing the Registration Form (SFL-461), attaching a check for $10 (payable to the “Secretary of State”), and sending to:

Secretary of State
Special Filings Unit
P.O. Box 942870
Sacramento, CA
94277-2870

Versions (5)


 

AARP

Download: Adobe PDF

 

 

 


California Attorney General

Download: Adobe PDF

 

 

 


California Hospital Association

Download: English, Spanish (español)

 

 

 


 

UCLA

Download: Adobe PDF

 

 

 


 

UCSF Medical Center

Download: Adobe PDF

 

 

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