Facebook Page
Learn
 / 
Advance Healthcare Planning
 / 
New Hampshire Advance Directive

New Hampshire Advance Directive

By 

Jennifer Mcgee

·

Updated on  

November 22, 2022
·

9 Mins

 Read

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 New Hampshire.  

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/if under the age of 18, is married or is the parent of a child.
  • 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
  • Other names for a Healthcare Power of attorney: Durable Power of Attorney
  • Other names for a Living Will: Living Will 
  • Proxy can decide on mental health issues: No

Who can be your witnesses in the New Hampshire Advance Directive?

Anyone can be your witness in New Hampshire 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 spouse,
  • Entitled to a share in the estate on your death,
  • Your supervising health care/mental healthcare provider/Advanced Registered Nurse Practitioner (ARNP), or any person acting under the direction and control of your attending physician or ARNP,
  • The operator or an employee of a  residential care provider (at least one witness).
Advance Directive New Hampshire

Who can be your Proxy/Agent in the New Hampshire Advance Directive?

Anyone can be your Proxy/Agent in New Hampshire 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 Proxy/Agent cannot be: 

  • your health care or residential care provider, 
  • an employee of your health care or residential care provider, unless such person is related to you.

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.

Your Patient Advocate Designation form will be valid after you and your witnesses sign it. However, your patient advocate and alternate (if any) must receive a copy of your document and date and sign an acceptance of his or her responsibilities before making any decisions on your behalf.

Note: You can appoint an Alternate Patient Advocate as well. The alternative Proxy/Patient Advocate 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.

Learn about the requirements of New Hampshire Last Will and Testament and  New Hampshire Last Will and Testament Template.

When does an Advance Directive come into effect in New Hampshire?

In New Hampshire, 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 New Hampshire 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 New Hampshire Advance Directive at anytime by in any way to convey your intention to revoke an Advance Directive, for instance:

  • A written revocation,
  • An oral revocation in presence of two witnesses (none of them should be your spouse/heir),
  • Tearing, burning, and obliterating or destroying the document in any other way,
  • Executing a new Advance Directive.

Note: A written revocation of the Advance Directive will be effective when you communicate it to your doctor, residential care provider, and Proxy/Agent. 

How to amend or change an Advance Directive? 

You can make changes or amend your Advance Directive at any time in New Hampshire 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.

New Hampshire rules for changing Marital status after making your Advance Directive 

Divorce from the spouse will not make any effect on the validity of the New Hampshire Advance Directive unless the spouse was named as an agent in the Durable Power of Attorney for Healthcare, your proxy/agent's designation will be suspended during any legal proceedings that could result in divorce or annulment of marriage. 

However, the divorce or annulment of marriage or legal separation will revoke the Proxy/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. 

Form 1 of the New Hampshire Advance Directive

There are two legal documents/forms in New Hampshire. An Advance Directive is Form 1 (which includes Living Will and Durable Power of Attorney) that allows you to refuse the medical treatment you would or do not prefer if there comes an event you lose the ability to make decisions and appointment of an Agent/Proxy.

Form 2 is New Hampshire’s “Organ Donation,” form which allows you to make decisions regarding organ donation, whole body, and the final disposition of your remains. 

Part 1: Appointment of Healthcare Agent

In Part 1 of Form 1 you can fill this form out and provide all the details about the appointment of the Healthcare Proxy/Agent along with the instructions to be followed by him.

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

New Hampshire Advance Directive Sample Form

PART 1: DURABLE POWER OF ATTORNEY FOR HEALTH CARE


Name (Principal's Name):__________

DOB: _____________________

Address:__________________


I choose the following person(s) as agent(s) if I have lost capacity to make health care decisions (cannot make health care decisions for myself). (If you choose more than one person, they will become your agent in the order written, unless you indicate otherwise.) 


A. Choosing Your Agent: 

I appoint _______________, of _______________, and whose phone number is _______________ to be my agent to make healthcare decisions for me. 


Alternate Agent: If the person above is not able, willing, or available, I appoint _______________, of _______________, and whose phone number is _______________ to be my alternate agent.


B. Limiting Your Agent's Authority or Providing Additional Instructions

____________________________________________________

____________________________________________________

Part 2: Individual’s Instructions (Living Will)

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.

New Hampshire Advance Directive Sample Form

SECTION 2: NEW HAMPSHIRE LIVING WILL 


If I suffer from an advanced life-limiting, incurable and progressive condition: 


___ A. I wish to have all attempts at life-sustaining treatment (within the limits of generally accepted health care standards) to try to extend my life as long as possible, no matter what burdens, costs or complications may occur. 


OR 


___ B. I do NOT wish to have any life-sustaining treatment attempted that I would consider to be excessively burdensome or that would not have a reasonable hope of benefit for me. I wish to receive only those forms of life-sustaining treatment that I would not consider to be excessively burdensome 

AND that has a reasonable hope of benefit for me. The following are situations that I would consider excessively burdensome: 

(Cross out and initial any of the below statements # 1-4 if you disagree.)


 __ 1. I do not wish to have life-sustaining treatment attempted if I am actively dying (medical treatment will only prolong my dying). 


__ 2. I do not wish to have life-sustaining treatment attempted if I become permanently unconscious with no reasonable hope of recovery. 


__ 3. I do not wish to have life-sustaining treatment attempted if I suffer from an advanced life-limiting, incurable and progressive condition and if the likely risks and burdens of treatment would outweigh the expected benefits

Part 3: Execution

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

New Hampshire state laws require the grantor to sign the form in presence of  witnesses or he can give an acknowledgment before the public notary. 

New Hampshire Advance Directive Sample Form

PART 3: EXECUTION


Alternative No. 1: Sign before witnesses.

I have received, reviewed, and understood the disclosure statement, and I have completed the durable power of attorney for health care and/or living will consistent with my wishes. 

I have attached __________ pages to better express my wishes. 

Signed this _____ day of __________, 20_____ 

Principal's Signature: __________


(Signature of Witness 1) (Date) Telephone Number(s)


(Signature of Witness 2) (Date) Telephone Number(s)


Alternative No. 2: Sign before a notary public or justice of the peace.


I have received, reviewed, and understood the disclosure statement, and I have completed the durable power of attorney for health care and/or living will consistent with my wishes. 

I have attached __________ pages to better express my wishes. 

Signed this _____ day of __________, 20_____ 

Principal's Signature: _________________________

Form 2 of the New Hampshire Advance Directive

New Hampshire After Death Sample Form

PART 1: DONATION OF ORGANS AT DEATH 


[   ] 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 New Hampshire 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 our presence. 

We signed this document as witnesses in the declarant’s presence and in each other’s presence. 


Witness 1 Date Address


Witness 2 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.

Fax my document instantly
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

“Should have done this before, had made it up to be really hard in my head. This was super easy!”

Frequently Asked Questions

What is an Advance Healthcare Directive New Hampshire?

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 New Hampshire?

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 New Hampshire?

Under New Hampshire 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 New Hampshire.

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 New Hampshire?

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 New Hampshire Medical Power of Attorney Form. Lastly, sign your document before subscribing to witnesses and a Notary Public.
Jennifer Mcgee
Parent to five young children. Expert in Estate Planning, Probate, and Family Law Matters. Volunteer with Victim’s Advocates in the local sheriff's department...
Read More
Got Questions?

Hi, I’m Jennifer McGee.

Co-founder & Head of Legal at TrulyWill

Feel free to book a call with me to help you with your estate plan.

Book a free session
Contents
Do you need any help? We have a free session for you!
Talk to our team and get all the help you need to create your estate plan.
Book a free session
Thinking of creating a will to secure your loved ones?
Start your estate plan online
  • Resume anytime
  • Done from your home
  • Expert support when you need it