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Living will and advance directive requirements in every US state

What counts as a valid healthcare directive changes at every state line: which document your state actually recognizes, how many witnesses have to watch you sign, whether a notary is involved at all, and whether being pregnant changes what your directive does. Pick your state for its own rules, in plain language, with the statutes to back them up.

51 jurisdictions. Statutes read: September 2026.

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Shaded by signing ruleWitnesses only (18)Witnesses or a notary (20)Both required (3)No witnesses required (1)Signing rule still being read (9)
Every jurisdiction, alphabetically

Find your state, from Alabama to Wyoming

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The common ground

What every state agrees on

1Capacity

You have to be an adult of sound mind. Nearly every statute puts adult at 18. Alabama puts it at 19.

2No gatekeeper

No state requires a lawyer to make one, and every state’s own form is free to use. So is Myend’s Healthcare Directive, with nothing behind a paywall.

3Reversible

You can revoke it at any time. Say so, tell your agent and your doctors, and replace the copies the people around you are holding.

The variables

What changes at the border

At least
20

jurisdictions let a notary stand in for the witnesses. Sign in front of two people, or in front of a notary, either one does it.

At least
18

want witnesses only, with no notary anywhere in the process.

At least
3

ask for both at once: North Carolina, South Carolina and West Virginia want witnesses and a notary.

At least
9

set a directive aside for the whole of a pregnancy. At least 11 more attach a condition, at least 11 say nothing at all, and at least 7 leave it to you on the form.

From the statutes

Small facts worth knowing

01

Massachusetts, Michigan and New York have no statutory living will at all. Each has an agent document instead.

02

New Mexico is the one state confirmed so far to require no witnesses whatsoever.

03

States use at least nine different words for the person you name: agent, surrogate, proxy, patient advocate, representative, attorney-in-fact.

04

At least 25 states put your instructions and your agent in one document. At least 19 keep them in two.

05

At least seven states run their own directive registry, so a hospital can pull the document up without anyone hunting for the paper.

How the data stays true

These pages come from a statute-by-statute read of every state's advance-directive law, done September 2026. Each rule carries its citation.

General information, not legal or medical advice. Witnesses or a notary are still needed to make the document valid.

Your state's healthcare directive, ready to sign

Myend prepares an advance directive formatted to your state's requirements. Free, yours to download when you are done.