Advance Directive Arizona

Jennifer Mcgee

Head of Legal at TrulyWill

‍When a person chooses to make a Living Will, along with the Medical Power of Attorney, these two legal documents become an Advance Directive.

An Advance Directive may include your sign, names of witnesses, their signatures, etc in adherence to your state’s requirements. Every state has different requirements to be followed. Some states ask for witnesses and notaries, others look for different criteria to be followed.

Likewise, some states consider Living Will and Advance Directive as different and separate documents, whereas others consider both documents the same. In some states, Living Will and Advance Directive are used interchangeably.

In this article, you will get a complete guide for making an Advance Directive for Healthcare in Arizona.

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TABLE OF CONTENTS

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Legal Requirements for a valid Advance Directive

Written by the grantor (maker of Advance Directive): Yes
Grantor must be:

Above the age of 18 years: Yes
Sound mind and memory: Yes

Signed by the grantor: Yes
Signed by Proxy/Agent: Yes
Proxy/agent accepts his role in writing: No
Witness required: Yes
Number of witnesses: 1
Signed by the witnesses: Yes
Number of documents required: 1
Other names for a Living Will: Living Will (optional)
Other names for a Healthcare Power of attorney: Healthcare Power of attorney
Proxy can decide on mental health issues: No

Who can be your witnesses in the Arizona Advance Directive?

Anyone can be your witness in Arizona if

He is an adult i.e., above 18 years of age,
He is a sound-minded person which means that he can understand the consequences of making an Advance Directive and the laws applied to it.

Note: Your witnesses cannot be:

Your healthcare proxy/agent,
your supervising health care provider/ his employer,
Related to you by blood, adoption, or marriage,
Entitled to a share in the estate on your death,
involved with the provision of your health care at the time the document is signed.

Arizona state laws require the witnesses to sign the form and give in writing their declaration or you can give acknowledgment before the public notary.

Who can be your Proxy in the Arizona Advance Directive?

Anyone can be your Proxy/Agent in Arizona if

He is an adult i.e., above 18 years of age, &
He is a sound-minded person which means that he can understand the consequences of making an Advance Directive and the laws applied to it.

Who cannot be your Proxy/Agent:

your supervising health care provider,
notary to whom you would give an acknowledgment.

Other than the above legal requirements, the Proxy/Agent should be:

Trustable to adhere to your wishes and intentions.
Trustable to defend you if there’s any disagreement about your medical care.
He wanted to be your Attorney in Fact of his own free will to take care of your health affairs.
He should not be your doctor or one of the caretakers.

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Note: You can appoint an Alternate Proxy as well. The alternative Proxy/Agent will step in if the first person you name as a proxy is unable, unwilling, or unavailable to act for you or if you decide to revoke his authority.

A certificate stating that you have been advised of your rights would be signed by your lawyer if you want your conservator (appointed under the Lanterman-Petris-Short Act) to be your agent, as well. Or you may mention in your advance directive a nomination for the individual appointed as your conservator, if necessary. The court will consider your nomination in any protective proceeding.

Notarization required for Arizona Advance Directive?

You can either get an Advance Directive executed by signing the form in presence of the witnesses (conditions applied) or get your signature notarized by signing an acknowledgment in front of the public notary.

When does an Advance Directive come into effect in Arizona?

In Arizona, an Advance Directive doesn’t come into effect on signing the form by the grantor, proxy, and witnesses. An Advance directive comes into effect only when the doctor declares that you are incapable of deciding on your behalf and have become debilitated due to illness or injury.

Note: Your Arizona Advance Directive will not be effective in any medical crisis or emergency unless you become incapacitated to understand and communicate your wishes and consent.

How can an Advance Directive be revoked?

You can revoke or terminate your Arizona Advance Directive anytime by:

A written revocation,
An oral revocation to your Proxy/Agent or health care provider, &
Tearing, burning, and obliterating or destroying the document in any other way.
Executing a new Advance Directive Form.
Or any other act that demonstrates your intent to revoke your document.

How to amend or change an Advance Directive?

You can make changes or amend your Advance Directive at any time in Arizona but once you have signed and witnessed/notarized it you have to resubmit a new document with the required changes. It is recommended to go through, double-check, and make sure of everything before signing the Advance Directive.

Arizona maintains an Advance Directive Registry. By filing your advance directive with the registry, your health care provider and loved ones may be able to find a copy of your directive in the event you are unable to provide one.

Sections of the Arizona Advance Directive Form

Section 1: Healthcare Power of attorney

You can fill this form out and provide all the details. The appointment of the Healthcare Proxy/Agent and his details will be filled along with the instructions for the Proxy/Agent to follow.

On the left side, you will find a gray box that contains all the instructions that will help you in the application process.

Arizona Advance Directive Sample Form

SECTION 1: HEALTHCARE POWER OF ATTORNEY

I, , as principal, (name) designate (name of agent) (address) _(home telephone number) _(work telephone number) as my agent for all matters relating to my health care, including, without limitation, full power to give or refuse consent to all medical, surgical, hospital and related health care.

This power of attorney is effective on my inability to make or communicate health care decisions. All of my agent’s actions under this power during any period when I am unable to make or communicate health care decisions or when there is…

…..

Section 2: Living Will (OPTIONAL)

This section states your wishes regarding medical care when your doctor determines that either:

that you are terminally ill & to prolong artificially your life you would need artificial life-sustaining procedures or your death will occur with or without the use of life-sustaining procedures, or
that you are in a persistent vegetative state.‍

Arizona Advance Directive Sample Form

SECTION 2: LIVING WILL

(OPTIONAL)

You may initial any combination of paragraphs 1, 2, 3 and 4 but if you initial paragraph 5 the others should not be initiated.

[ ] 1. If I have a terminal condition I do not want my life to be prolonged and I do not want life-sustaining treatment, beyond comfort care (treatment given to protect and enhance my quality of life), that would serve only to artificially delay the moment of my death.

[ ] 2. If I am in a terminal condition or an irreversible coma or a persistent vegetative state that my doctors reasonably feel to be irreversible or incurable, I do want the medical treatment necessary to provide care that would keep me comfortable, but I do not want the following

• cardiopulmonary resuscitation, for example, the use of drugs, electric shock and artificial breathing; or

• artificially administered nutrition and hydration; or

• to be taken to a hospital if at all avoidable.

[ ] 3. Notwithstanding my other directions, if I am known to be pregnant, I do not want life-sustaining treatment…..

Section 3: Autopsy

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Arizona Advance Directive Sample Form

SECTION 3 : AUTOPSY

(OPTIONAL)

If one of the statements below reflects your wishes, initial on the line next to that statement.

If you choose to initial a statement, initial only one statement. You do not have to initial any of the statements.

[ ] 1. I do not consent to an autopsy in any situation in which an autopsy is not otherwise required by law.

[ ] 2. I consent to an autopsy.

[ ] 3. My agent may give consent to or refuse an autopsy.

Section 4: Organ donation

Arizona Advance Directive Sample Form

SECTION 4 : ORGAN DONATION

(OPTIONAL)

If any of the statements below reflects your desire, initial on the line next to that statement. You do not have to initial any of the statements. If you do not initial any of the statements, your agent and your family will have the authority to make a gift of all or part of your body under Arizona law.

[ ] I do not want to make an organ or tissue donation and I do not want my agent or family to do so.

[ ] I have already signed a written agreement or donor card regarding organ and tissue donation with the following individual or institution:

Pursuant to Arizona law, I hereby give, effective on my death: Any needed organ or parts. The following part or organs listed below:

…..

Section 5: Physician Affidavit

Arizona Advance Directive Sample Form

PHYSICIAN AFFIDAVIT (OPTIONAL)

I, Dr.____ have reviewed this guidance document and have discussed with any questions regarding the probable medical consequences of the treatment choices provided above.

This discussion with the principal occurred on (date) I have agreed to comply with the provisions of this directive.

(signature of physician)

Section 6: Funeral & burial disposition

Arizona Advance Directive Sample Form

FUNERAL & BURIAL DISPOSITION (OPTIONAL)

My agent has authority to carry out all matters relating to my funeral and burial disposition wishes in accordance with this power of attorney, which is effective upon my death.

My wishes are as follows:

[ ] Upon my death, I direct my body to be buried (as opposed to cremated).

[ ] Upon my death, I direct my body to be buried in . Upon my death, I direct my body to be cremated.

[ ] Upon my death, I direct my body to be cremated, with my ashes to be .

My agent may make all funeral and burial disposition decisions.

Section 7: Execution

You must sign in the presence of two witnesses. The details of the witnesses along with their signs are also required.

Arizona Advance Directive Sample Form

SECTION 7 : EXECUTION

OPTION 1: Sign before a Witness _______________________ ___________________________________ (date) (sign your name) __________________________________________________________ (print your name) __________________________________________________________ (address) __________________________________________________________ (city) (state) (zip code)

OPTION 2: Sign Before a Notary

This health care directive is made under Section 36-3221, Arizona Revised Statutes, and continues in effect for all who may rely on it except those to whom I have given notice of its revocation.

(signature of principal) (date) (time) State of Arizona County of The foregoing instrument was signed or acknowledged before me this day of ____ by (principal)

…..

Give photocopies of the signed original to your agent and alternate agent, doctor(s), family, close friends, clergy, and anyone else who might become involved in your health care. If you enter a nursing home or hospital, have photocopies of your document placed in your medical records.

Be sure to talk to your agent(s), doctor(s), clergy, family, and friends about your wishes concerning medical treatment. Discuss your wishes with them often, particularly if your medical condition changes

How can TrulyWill help?

We provide a quick and hassle-free online platform to create a Will or Trust to plan your estate or healthcare. In just 3 simple steps just like 1, 2 & 3 you can make a valid Estate or Healthcare Plan at the most affordable cost online. Guess what, we give a 30-day money-back offer!

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What does an Estate plan do? Why do I need it?

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Advance Directive Arizona

Legal Requirements for a valid Advance Directive

Who can be your witnesses in the Arizona Advance Directive?

Who can be your Proxy in the Arizona Advance Directive?

Notarization required for Arizona Advance Directive?

When does an Advance Directive come into effect in Arizona?

How can an Advance Directive be revoked?

How to amend or change an Advance Directive?

Sections of the Arizona Advance Directive Form

Section 1: Healthcare Power of attorney

Section 2: Living Will (OPTIONAL)

Section 3: Autopsy

Section 4: Organ donation

Section 5: Physician Affidavit

Section 6: Funeral & burial disposition

Section 7: Execution

How can TrulyWill help?