Advance Healthcare Planning
Advance Healthcare Directive Missouri

Advance Healthcare Directive Missouri


Jennifer Mcgee


Updated on  

March 17, 2023

9 Mins


 When a person chooses to make a Living Will, along with the Medical POA, 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 Missouri.  

Legal Requirements for a valid Advance Directive

  • Written by the grantor/declarant (i.e. the maker of an 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: No
  • Proxy/agent accepts his role in writing: No
  • Witness required: Yes
  • Number of witnesses: 2
  • Signed by the witnesses: Yes
  • Number of documents required: 1 
  • Other names for a Living Will: Healthcare Choices Directive
  • Other names for a Healthcare Power of attorney: Durable Power of Attorney for Healthcare
  • Proxy can decide on mental health issues: No
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Who can be your witnesses in the Missouri Advance Directive?

In Missouri, only Part 2 (Living Will) of the Advance Directive Form requires you to sign and date it in the presence of two witnesses to be effective. 

Anyone can be your witness in Missouri 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.
Advance Directive Missouri

Who can be your Proxy in the Missouri Advance Directive?

Anyone can be your Proxy/Agent in Missouri 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.

Your Proxy/Agent cannot be:

  • Your supervising health care provider/ his employer,
  • The operator or an employee of a healthcare facility where you’re receiving care.


  • That person is related to you by blood, adoption, or marriage i.e. your spouse, parent, child, grandparent, sibling, or grandchild.

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.

Notarization required for Missouri Advance Directive?

Missouri state laws require the grantor to sign the form in presence of  witnesses when he fills the Part 2 of the form i.e. Healthcare Choices Directive or he can give an acknowledgment before the public notary when you fill the Part 1 of the form i.e. Durable Power of Attorney.

If you fill out both Part 1 and Part 2, you will need to have your signature both witnessed and notarized. 

When does an Advance Directive come into effect in Missouri?

In Missouri, 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 Missouri Advance Directive will not be effective in any medical crisis or emergency unless you are declared incapacitated to understand and communicate your wishes and consent by your doctor.

How can an Advance Directive be revoked?

You can revoke or terminate your Missouri Advance Directive (other than the designation of your agent) at anytime by:

  • A written revocation or directing any other person to write on your behalf,
  • An oral revocation,
  • Tearing, burning, and obliterating or destroying the document in any other way,
  • Executing a new Advance Directive, and
  • In any way which unambiguously conveys your intent to revoke.

Note: You may revoke the designation of your agent only by communicating about it to your supervising health-care provider, treating physician, and your agent.

How to amend or change an Advance Directive? 

You can make changes or amend your Advance Directive at any time in Missouri but once it was witnessed and signed 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.

Missouri rules for changing Marital status after making your Advance Directive 

Divorce from the spouse will not make any effect on the validity of the Missouri Advance Directive unless the spouse was named as an agent in the Durable Power of Attorney for Healthcare, the divorce or annulment of marriage or legal separation will revoke the healthcare agent's power with immediate effect.

If you would prefer that no effect should be there on the Advance Directive after marriage or on divorce, you may add it as a Special Instruction in your Advance Directive for healthcare. 

Parts of the Missouri Advance Directive Form

Part 1: Appointment of Healthcare Agent

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. 

Missouri Advance Directive Sample Form


I, , appoint 

Name: Address: 

as my agent for health care choices when I am unable to make decisions or communicate my wishes. In the case the person above cannot serve as my agent, or if I am divorced from or legally separated from the agent above, I appoint the person below: 

Name: Address: 

This alternate agent may make health care decisions for me when I am unable to do so or to communicate my wishes. 

This durable power of attorney becomes effective when two physicians certify that I am incapacitated and unable to make and communicate healthcare choices. 

You may choose to have one physician, instead of two, to determine whether you are incapacitated. 

If you want to exercise this option — allowing one physician to determine whether you are incapacitated — initial here_______

Part 2: Treatment Preferences

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.

Missouri Advance Directive Sample Form


If I have a terminal illness or condition and there is no reasonable hope I will recover, or if I am persistently unconscious, I direct all of the life prolonging procedures 

I have initiated below to be withheld or withdrawn. 

I direct the following treatments to be withheld or withdrawn: (initial all that apply) 

[   ] Surgery or other invasive procedures 

[   ] Cardiopulmonary resuscitation (CPR) to restart my heart or breathing 

[   ] Antibiotics Dialysis Mechanical ventilator (respirator) 

[   ] Artificially supplied nutrition and hydration (including tube feeding) 

[   ] Chemotherapy Radiation therapy 

[   ] All other “life-prolonging” medical treatments 

or surgeries that are merely intended to keep me alive without reasonable hope of making me better or curing my illness or injury. 

Organ Donation Choices (initial only one) 

[   ] I consent to the donation of my organs or tissues. I realize my body may need to be maintained artificially after my death until my organs can be removed. 

[   ] I refuse to make anatomical gifts for part or all of my body. I prohibit my agent from consenting to such gifts before or after my death.

Part 3: Execution

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

Missouri Advance Directive Sample Form


IN WITNESS THEREOF, I have executed this document on this day of , in the year of . Signature: Print name: Address: 

If you filled out Part II, you must have your signature witnessed by two people who are at least 18 years of age. The person who signed this document is of sound mind and voluntarily signed this document in our presence. 

Each of the undersigned witnesses is at least 18 years of age. 

Witness #1 Signature: Print name: Address: 

Witness #2 Signature: Print name: Address: 

If you filled out Part I, you must have your advance directive notarized. 



On this day of , in the year of , personally appeared before me the person signing, known by me to be the person who completed this document and acknowledged it as his/her free act and deed. 

IN WITNESS WHEREOF, I have set my hand and affixed my official seal in the County of , State of Missouri, the day and year first above written. 

Notary Seal 

(Signature of Notary Public

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 an Advance Healthcare 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.

Does an attorney have to draft an advance directive in Missouri?

The procedure of creating advance directives is simple, you do not require an attorney though you may choose to consult one. However, an advance directive either it is written or oral needs to be witnessed by two individuals.

Who makes medical decisions if you are incapacitated in Missouri?

Under Missouri law, incapacity means when a physician declares that the individual can longer give informed consent. Any person may designate someone to make health care decisions on their behalf should they become incapacitated in Missouri.

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.

How do I get a medical power of attorney in Missouri?

It is the same as creating a document of Advance Directive. Firstly, choose Your Surrogate/Acting Agent, be specific on what decisions your Power of Attorney can make for you, and fill out your Missouri Medical Power of Attorney Form. Lastly, sign your document before subscribing to witnesses and a Notary Public.
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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