Completing your Advance Directive

Can you afford to not have an Advance Directive?


Completing the Advance Directive

Read each line carefully and strike out any that does not apply to you, or that you do not agree with. There are extra spaces for you to fill in any circumstances not covered – e.g. you may have a hereditary condition you want to address.

Add your initials to each line where marked, to confirm that this is your decision.

Signing and making copies

You will need 2 (two) witnesses to your signature. The witness must sign the Advance Directive Form and also write his/her initials beside yours. The witnesses in effect confirm that you have signed the document in their presence and in the presence of each other.

Make copies of the form before you sign and date, so that each copy has the original signatures.

The following persons may not act as witness 

  • A person named in the directive as a Proxy;
  • The spouse or partner of a person named in the directive as an Proxy;
  • Your own spouse;
  • A person who signs your directive on your behalf if you are unable to do so and to whom you are giving your instructions verbally.

Talk to your doctor

Talk to your doctor or medical healthcare giver and ask that a copy of the directive be entered in your medical records. Give a copy to whoever will be making decisions on your behalf if you cannot do so for yourself. Keep a copy where it can be easily found in an emergency situation. Leave a note in a prominent place – perhaps with a fridge magnet – saying where to find your Advance Directive and who to call in an emergency.   

Changing your mind

You can always change your mind. This is important, since we all have to adjust to changes in life circumstances, including health status. Therefore we advise that you review your Advance Directive at least every three years. If there are no changes to be made, sign it again with the new date. There is space at the bottom of the form for you to do this.

There is no requirement under law that you update your signature. However, we advise you to do so. Your Advance Directive may not come into effect for some considerable time. If you have not updated your signature, there is no evidence that you have recently reviewed your Advance Directive and that your wishes are unchanged.

Your new signature and date has to be witnessed regardless if you are making changes to the terms of your directive or not.

If your medical condition has changed, or if you have reconsidered some of the answers you wrote down, ask us to send you a new form, and start over. Begin by revoking your previous Advance Directive and continue on as before.

Also, remember that we all adjust to changes in life circumstances, including health status, so you may well change your mind.  You may find that your actual symptoms are not as ghastly as you’d imagined they would be when completing this document.  Be sure to tell everyone involved in your care that you have revised your Advance Directive. 

Some good advice from the American Bar Association

Re-examine your health care wishes every few years or whenever any of the “Five D’s” occur:

  1. Decade – when you start each new decade of your life.
  2. Death – whenever you experience the death of a loved one.
  3. Divorce – when you experience a divorce or other major family change.
  4. Diagnosis – when you are diagnosed with a serious health condition.
  5. Decline – when you experience a significant decline or deterioration of an existing health condition, especially when it diminishes your ability to live independently.

Our recommendation would be to re-examine it annually –
e.g. on your birthday, or, perhaps, New Year’s Day.


Providing many trusted individuals with copies of your advance directive will ensure that your health care wishes are met in the event that you cannot express your wishes for yourself. Keep the original copy of the Advance Directive in a place that can easily be found, and give copies to:

  • Your chosen Medical Proxy (with directions on where to find the original).
  • Family members or other loved ones.
  • Your primary doctor, hospital, or health care institution. Ask that a copy is placed in your medical record and make sure your doctor will support your wishes.
  • Anyone named in the directive.

A copy can also be sent to your attorney or kept in a safety deposit box or anywhere else you may keep copies of a will or other important papers. Be sure that you have discussed the directive with the person you designate as your Medical Proxy and that he or she understands your wishes and the responsibilities involved.