Who fills this out
The principal (patient) fills out and signs. The named healthcare agent and any alternate agent do not sign at execution; their job begins later, when the principal cannot decide for themselves.
When to file
Not filed with any court. The signed original goes to the agent and a copy goes to the primary care doctor and the hospital chart. Free registration with the Arizona Advance Directive Registry is recommended.
What you will need
- Arizona statutory form (ADHS or hospital packet).
- Full legal name of agent and at least one alternate.
- One qualifying adult witness or notary.
- Optional mental health care power of attorney rider for psychiatric admissions.
Common mistakes
- No alternate agent. If the first agent is unavailable, doctors fall back to default Arizona surrogate rules under A.R.S. § 36-3231.
- Using an ineligible witness. Spouses, heirs, healthcare providers, and people financially responsible cannot witness.
- Forgetting the mental health rider. Without it, the agent cannot consent to inpatient mental health treatment.
- Naming co-agents who disagree. Arizona allows only one acting agent at a time; alternates are sequential, not simultaneous.
Questions families ask
Can my agent refuse life support on my behalf?
Yes, if your living will or the healthcare POA itself grants that authority. Many families use both documents in tandem.
Does HIPAA need a separate authorization?
The Arizona statutory form includes HIPAA release language, but a stand-alone HIPAA authorization is still useful for adult children under 26 on a parent's insurance.
Related forms
An Arizona durable financial power of attorney lets the principal name an agent to manage bank accounts, real estate, and tax matters if the principal loses capacity. Under A.R.S. § 14-5501, the document is valid only if signed by the principal, witnessed by one adult who is not the agent, and notarized at the same time.
An Arizona living will under A.R.S. § 36-3262 tells doctors what life-sustaining treatment you want or refuse if you cannot speak for yourself. It must be signed by you and either notarized or witnessed by one adult who is not your healthcare provider, your spouse, an heir, or directly financially responsible for your care.