Vermont Advance Directive Form

Catholic Advance Directive

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Vermont Dept. of Health

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HealthVermont.org (long-form)

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HealthVermont.org (short-form)

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University of Vermont

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An advance directive may be registered with the Vermont Advance Directive Registry by completing and submitting a Combined Registration Agreement & Change Form along with a copy of the directive. Registration is free for all Vermont residents.

The form may be submitted online or by mail to the following address:

Vermont Ethics Network
61 Elm Street, Suite 1
Montpelier, VT 05602

The principal can revoke their advance directive at any time by executing a new directive, signing a written revocation, personally informing their physician of the revocation, or burning, tearing, or obliterating the original form.^[2]

“Advance directive” means a written record executed pursuant to section 9703 of this title, which may include appointment of an agent, identification of a preferred primary care clinician, instructions on health care desires or treatment goals, an anatomical gift, disposition of remains, and funeral goods and services. The term includes documents designated under prior law as a durable power of attorney for health care or a terminal care document.^[3]

Vermont law does not specify a particular form that must be used for an advance directive.