Advance Healthcare Planning
Advance Directive Indiana

Advance Directive Indiana


Jennifer Mcgee


Updated on  

March 17, 2023

9 Mins


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 Indiana.  

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/by any other person on behalf of grantor
  • Signed by Proxy/Agent: No
  • Proxy/agent accepts his role in writing: No
  • Witness required: It’s not a mandate under State laws but it’s a good idea to sign in presence of at least one witness.
  • Number of witnesses: 2
  • Signed by the witnesses: Yes
  • Number of documents required: 2 (Advance Directive Form + Organ Donation Form)
  • Other names for a Living Will: Declaration
  • Other names for a Healthcare Power of attorney: Durable Power of attorney for healthcare/Appointment of Health Care Representative
  • Proxy can decide on mental health issues: No
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Who can be your witnesses in the Indiana Advance Directive?

Anyone can be your witness in Indiana if;

  • He is an adult i.e., above 18 years of age, and
  • 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Note: If you choose in your Declaration to have life prolonging treatments withheld or withdrawn, your witness cannot be: 

  • a person signing the Declaration on your behalf if you are unable to sign it yourself, 
  • your child, spouse, or parent, 
  • a person entitled to a share in your estate, and
  • a person who takes care of your medical care expenses financially.
Advance Directive Indiana

Who can be your Proxy in the Indiana Advance Directive?

Anyone can be your Proxy/Agent in Indiana if

  • He is an adult i.e., above 18 years of age, and
  • 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.

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.

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.

When does an Advance Directive come into effect in Indiana?

In Indiana, an Advance Directive becomes legally valid but 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 own and have become debilitated due to illness or injury.

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

Learn about the requirements of Indiana Last Will and Testament and Indiana Last Will and Testament Template.

How can an Advance Directive be revoked?

The powers given to the healthcare proxy/representative under Part One of Advance Directive Form would be revoked by telling either orally or in writing your representative or healthcare provider that you are revoking the healthcare representative’s powers.

You can revoke or terminate your instructions under Part Two of Indiana Advance Directive anytime by:

  • A written revocation,
  • An oral revocation, and
  • Tearing, burning, and obliterating or destroying the document in any other way or directing anyone to destroy it in your presence,
  • Executing a new Advance Directive.

Note: Your revocation of Part Two becomes effective once you notify your doctor.

How to amend or change an Advance Directive? 

You can make changes or amend your Advance Directive at any time in Indiana but once you have signed and witnessed/notarized it you have to remake 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.

Indiana rules for pregnancy after making your Advance Directive

Indiana state laws mention that a pregnant patient’s preferences in the Advance Directive will not be honored if it is possible that the fetus is viable and could develop to the point of live birth with continued application of life-sustaining treatment. 

Document 1: Living Will Declaration + Durable Power of Attorney= Advance Directive

Parts of the Indiana Advance Directive Form

Part 1: Durable Power of attorney for health care

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.

Indiana Advance Directive Sample Form


Patient Last Name Patient First Name Patient Middle Initial Patient Birthday (mm/dd/yyyy) Medical Record Number of HealthcareFacility or Provider (optional) Healthcare Facility or Provider (optional) 

Appointment of Health Care Representative I, being at least eighteen (18) years of age, of sound mind, and capable of consenting to my health care, hereby appoint the person(s)................................................................................................................. To the extent appropriate, my health care representative may also discuss this decision with my family and others to the extent they are available. 

I specify the following terms and conditions (if any): 

Name of Representative Appointed 

Address of Representative 

(number and street, city, state, and ZIP code) 

Telephone Number of Representative Signature of Patient / Appointor or Designee 

(must be signed in the appointor’s presence) 

Printed Name of Patient / Appointor or Designee Date of Appointment (mm/dd/yyyy) 

Signature of Witness 

Printed Name of Witness Date (mm/dd/yyyy)

Part 2: Declaration

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

  • that you are terminally ill and 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.

Indiana Advance Directive Sample Form


DECLARATION This declaration is made this day of (month, year). I, being of sound mind, willfully and voluntarily make known my desires that my moment of death shall not be artificially postponed. If at any time I should have an incurable and irreversible injury, disease, or illness judged to be a terminal condition by my attending physician who has personally examined me and has…………….such death-delaying procedures, it is my intention that this declaration shall be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and accept the consequences from such refusal. 

Signed City, County and State of Residence 

The declarant is personally known to me and I believe him or her to be of sound mind. I saw the declarant sign the declaration in my presence (or


The declarant has been personally known to me and I believe (him/her) to be of sound mind. 

I am competent and at least eighteen (18) years of age. 

Witness,_________ Date (month, day, year) 

Witness,__________ Date (month, day, year)

Document 2: Donation of organs form

Indiana Advance Directive Sample Form


[   ] I do not want to make an organ or tissue donation and I do not want my attorney for health care, proxy, or other 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: 

Name of individual/institution: 

Pursuant to Indiana law, I hereby give, effective on my death: Any needed organ or parts. 

The following part or organs listed below: 

For (initial one): 

Any legally authorized purpose. Transplant or therapeutic purposes only. 

Declarant name: 

Declarant signature: ______ Date: 

The declarant voluntarily signed or directed another person to sign this writing in my presence. 

Witness Date Address

I am a disinterested party with regard to the declarant and his or her donation and estate. 

The declarant voluntarily signed or directed another person to sign this writing in my presence. 


Date_ Address________

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.

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Frequently Asked Questions

What is advanced health care directive Indiana?

An Advance Directive is a legal-written document about your future medical care. It is a gift to family members and friends so that they won't have to guess what you want if you no longer can speak for yourself.

Is Five Wishes legal in Indiana?

Think of it as a living will or as a conversation piece you can use to collect all your end-of-life wishes in a single place. Five Wishes is a legal document in all states but eight states i.e. Alabama, Indiana, Kansas, New Hampshire, Ohio, Oregon, Texas, and Utah require their own official documentation.

What are the 2 major challenges with advance directives?

Advance directives have limitations. For example, an older adult may not fully understand treatment options or recognize the consequences of certain choices in the future. Sometimes, people change their minds after expressing advance directives and forget to inform others.

Does an advance directive need to be notarized in Indiana?

An Advance Directive must be signed by the individual in the presence of two witnesses or a notarial officer (such as a notary public).

What is the difference between advance care planning and an advance directive?

The Advance Directive is a formalized version of your Advance Care Plan. An Advance Directive is a document through which you plan your healthcare and your preferences for your future care.
Jennifer Mcgee
Parent to five young children. Estate Planning, Probate, and Family Law Attorney. Volunteer with Victim’s Advocates in the local sheriff's department...
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Jennifer Mcgree
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