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California Advance Directive Form

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California Advance Directive Form

Updated February 26, 2024

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 undergoing high-risk medical procedures.

Signing Requirements

A principal is required to execute an advance directive in the presence of two (2) witnesses or a notary public.[1]

A digital signature is also accepted if it meets the standards of the National Institute of Standards and Technology.[2]

Versions (5)

  1. AARP
  2. California Attorney General
  3. California Hospital Assoc.
  4. UCLA Health
  5. UCSF Medical Center
1. AARP

Download: PDF

2. California Attorney General

Download: PDF

 

3. California Hospital Association

Download: English, Spanish (español)

4. UCLA Health

Download: PDF

5. UCSF Medical Center

Download: PDF

Registration

An individual can register an advance directive[3] 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

Revocation

A principal that has executed an advance directive may revoke its designation by:

  • Signing a written revocation form by the principal;[4]
  • If a spouse is an agent, and the marriage is dissolved or annulled;[5] or
  • By authorizing a new advance directive.[6]

State Definition

“Advance health care directive” or “advance directive” means either an individual health care instruction or a power of attorney for health care.”[7]

Statutory Form

The State of California requires a statutory form to be used by residents.[8]

Sources

  1. PROB § 4673(a)(3)
  2. PROB § 4673(b)
  3. PROB § 4800
  4. PROB § 4695
  5. PROB § 4697
  6. PROB § 4698
  7. PROB § 4605
  8. PROB § 4701