Advance Healthcare Planning
Iowa Advance Directive

Iowa Advance Directive


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. 

Similarly, some states distinguish between an advance directive and a living will, while others see them as one document. In some states, the terms "Advance Directive" and "Living Will" are interchangeable.
You will find a thorough explanation of how to create an advance healthcare directive in Iowa in this post.

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: 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: 2 (Advance Directive Form + Organ Donation Form)
  • Other names for a Living Will in Iowa: Declaration
  • Other names for a Healthcare Power of attorney in Iowa: 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 Iowa Advance Directive?

Anyone can be your witness in Iowa 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: Your witnesses cannot be: 

  • Your healthcare proxy/agent,
  • your supervising health care provider/ his employer,
  • Related to you by blood, adoption, or marriage within the third degree of consanguinity. (at least one witness).

In other words, your witness must be connected to you more distantly by marriage than your step uncles, step aunts, step nephews, step nieces, step great grandparents, and step great grandchildren, or by blood than your uncles, aunts, nephews, nieces, and great-grandparents.

Advance Directive Iowa

Who can be your Proxy in the Iowa Advance Directive?

Anyone can be your Proxy/Agent in Iowa 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.

Who cannot be your Proxy/Agent:

  • your supervising health care provider, 
  •  if you are receiving care  at a health care institution then its employee.


  • the employee is related to you by blood, marriage, or adoption within the third degree of consanguinity. 

This means that your agent must be more distantly related to you by marriage than your step uncles, step aunts, step nephews, step nieces, step great grandparents, and step great grandchildren, or by blood than your uncles, aunts, nephews, nieces, and great-grandparents.

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 Iowa Advance Directive?

You can execute an advance directive by signing the document in front of witnesses, or you can have your signature notarized by signing an acknowledgment in front of a notary public.

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

When does an Advance Directive come into effect in Iowa?

In Iowa, when the grantor, proxy, and witnesses sign the paperwork, the advance directive becomes legally binding but does not take effect immediately.
Only when the doctor certifies that you are disabled due to illness or accident and are unable to make decisions for yourself does an advance directive go into force.

Note: Unless you become unable to understand and convey your preferences and permission, your Iowa Advance Directive will not be effective in any medical crisis or emergency.

How can an Advance Directive be revoked?

You can revoke or terminate your Iowa Advance Directive anytime in any way either 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 becomes effective when you, or someone else, communicate this revocation to your attending physician. If you decide to declare a designee to make choices regarding the final disposition of your remains, you may only revoke that power in a signed writing.  

How to amend or change an Advance Directive? 

In Iowa, you can update or edit your advance directive at any time, but after you've signed it and had it witnessed or notarized, you must create a new document with the necessary revisions. Before signing the advance directive, it is advised to carefully review, confirm, and ensure everything.

Iowa rules for divorce after making your Advance Directive 

Divorce from the spouse will not make any effect on the validity of the Iowa Advance Directive unless the spouse was named in Part 1 as the Proxy/Agent then and your marriage ends, your agent’s power is automatically revoked.

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

Parts of the Iowa 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.

Iowa Advance Directive Sample Form


I hereby designate , of 

(name of attorney-in-fact) (address) (city) (state) (zip code) (home telephone number) (work telephone number) 

as my attorney-in-fact (my “agent”) and give to my agent the power to make health-care decisions for me. 

This power exists only when I am unable, in the judgment of my attending physician, to make those health-care decisions. The attorney in fact must act consistently with my desires as stated in this document or otherwise made known. 

In the event the person I designate above is unable, unwilling or unavailable to act as my agent, I hereby designate _, of 

(name of alternate agent) (address) (city) (state) (zip code) (home telephone number) (work telephone number)


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.

Iowa Advance Directive Sample Form


If I should have an incurable or irreversible condition that will result either in death within a relatively short period of time or a state of permanent unconsciousness from which, to a reasonable degree of medical certainty, there can be no recovery, it is my desire that my life not be prolonged by the administration of life-sustaining procedures. 

If I am unable to participate in my health-care decisions, I direct my attending physician to withhold or withdraw life-sustaining procedures that merely prolong the dying process and are not necessary to my comfort or freedom from pain. Additional, specific directions (if any): 


Limitations or special wishes, if any, list below:


Part 3: Execution

Iowa Advance Directive Sample Form



Signed this day of , (day) (month) (year) 

Signature Alternative No. 1, Witnesses: 

The declarant is known to me and voluntarily signed this document in my presence. 

Witness 1


Witness 2


I further declare that I am not a relative of the declarant by blood, marriage, or adoption within the third degree of consanguinity. - OR - (signature of first or second witness) 

Alternative No. 2: Acknowledgement by Notary Public: 

On ______, before me came , 

(Date) (name of declarant) whom I know to be such a person, and the declarant did then execute this declaration. 

Sworn to before me this day of ______

Document 2: Donation of organs form

Iowa 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 Iowa 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 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.

Can I write my own advanced directive?

You can write an Advance Directive yourself or you can make one using our free form. The form is called an Advance Decision, but it can still be used in Iowa even though it has a different name. You can also make an Advance Directive online at TrulyWill.

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.

What makes an advance decision invalid in Iowa?

Only when you are 18 years old and have the mental capacity—that is, when you were aware of the decision you were making at the time and its implications—can it be said that you have made an advance decision. Your Iowa Advance Directive will be void if these requirements are not met.

Does advance directives have nothing to do with mental capacity?

An advance directive document provides how you would like to be treated in the future if you can't decide for yourself due to any disease or accident. You can only make an advance directive if you have the mental capacity otherwise it would not be honored and will be considered invalid.
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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