Making someone your health care proxy requires completing a legal form specific to your state, signing it with witnesses or a notary, and giving copies to your proxy, your doctors, and your hospital. The process itself is straightforward and doesn’t require a lawyer, but choosing the right person and having the right conversations beforehand matters just as much as the paperwork.
A health care proxy is someone you legally authorize to make medical decisions on your behalf if you become unable to make them yourself. Depending on your state, this person may also be called your health care agent, attorney-in-fact, or patient advocate. The document that names them is a type of advance directive, sometimes called a health care power of attorney.
Choosing the Right Person
Before you touch any paperwork, spend time thinking about who you’re asking to fill this role. Your proxy doesn’t need medical knowledge. What they need is the ability to advocate for your wishes under pressure, even when family members, friends, or doctors push back. The National Institute on Aging recommends asking yourself several key questions: Do you trust this person with your life? Will they honor your wishes even if they personally disagree? Can they handle conflict from other family members or medical staff? Are they comfortable discussing difficult topics like end-of-life care?
Proximity matters too. If your proxy lives across the country, consider whether they could realistically travel to be with you during a medical crisis or communicate effectively with your care team from a distance. Many people default to a spouse or adult child, but a close friend who is level-headed and emotionally available can be a better choice than a relative who would struggle to make hard calls.
You should also name an alternate proxy in case your first choice is unavailable or unable to serve when the time comes. Most state forms include a space for this.
Have the Conversation First
Naming someone on a form is not enough. Your proxy needs to understand your values and preferences in detail so they can make decisions that reflect what you would want, not what they would want for you. This conversation should cover specific scenarios:
- Life-sustaining treatment: Would you want to be kept on a ventilator indefinitely, or only for a limited time? Under what circumstances would you want life support withdrawn?
- Resuscitation: If your heart stops, do you want CPR attempted? Your answer may depend on your overall health at the time.
- Artificial nutrition and hydration: If you can’t eat or drink on your own, do you want tube feeding?
- Pain management: Would you prioritize comfort over consciousness if the two conflicted?
- Quality of life: What conditions would you consider unacceptable? For some people, permanent loss of the ability to communicate or recognize loved ones crosses that line.
These are uncomfortable topics, but your proxy can’t advocate for you if they’re guessing. Revisit the conversation periodically, especially after major life changes like a new diagnosis, a marriage, or a divorce.
Completing the Legal Form
Every state has its own health care proxy form, and using your state’s version is the simplest way to ensure the document is legally valid. You can find free forms through your state’s department of health, your state bar association, or organizations like the American Bar Association. You do not need an attorney to complete the form, though consulting one can help if your situation is complex.
The form will ask for basic information: your name, your proxy’s name and contact information, and your alternate proxy’s details. Some forms include space to specify your treatment preferences, though this is optional. The core legal function of the document is naming your agent, not listing every medical scenario.
Witness and Notarization Rules
Most states require two adult witnesses to watch you sign the form and then sign it themselves. The person you’re naming as your proxy typically cannot serve as a witness. Some states also prohibit your doctor or employees of your health care facility from witnessing.
Notarization requirements vary. In New Jersey, for example, you can either have two witnesses or get the document notarized, but you don’t need both. Some states require notarization in addition to witnesses. Check your state’s specific rules, as a form that doesn’t meet your state’s requirements may not hold up when it’s needed most.
How a Health Care Proxy Differs From a Living Will
People often confuse these two documents, but they serve different purposes. A living will is a written statement of your specific medical wishes, particularly around treatments you do or don’t want. It does not name anyone to make decisions for you. A health care proxy names a decision-maker but doesn’t necessarily spell out every preference in detail.
The two documents work best together. A living will gives your proxy (and your doctors) a written record of your wishes. Your proxy fills in the gaps for situations your living will didn’t anticipate. One practical difference worth knowing: a living will, because it’s a direct statement of your wishes, tends to be honored across state lines more reliably than a proxy designation, which is governed by the specific laws of the state where it was created.
Distributing Copies
A proxy form locked in a safe deposit box is useless during a medical emergency. Once your document is signed and witnessed, give copies to:
- Your health care proxy (and your alternate proxy)
- Your primary care doctor, who can add it to your medical record
- Any specialists you see regularly
- Your local hospital, if you have a preferred one
- Close family members, so they know your proxy has authority and who that person is
Keep the original in a place that’s easy to access, not a locked safe. Some people also carry a wallet card noting that they have a health care proxy on file and listing the proxy’s contact information.
When Your Proxy’s Authority Begins
In most states, your proxy’s authority kicks in only when a doctor determines you’ve lost the capacity to make your own medical decisions. This could happen because you’re unconscious, heavily sedated, or experiencing cognitive decline that prevents informed consent. As long as you can communicate and understand your options, you retain full control over your own care.
This timing creates a gap worth knowing about. Under federal privacy rules (HIPAA), your proxy gains the same right to your medical information that you have, but only once their authority is active. In most states, that means your proxy can’t access your records or talk to your doctors on your behalf before you lose capacity, unless you’ve separately authorized that access. If you want your proxy involved in your care before a crisis, ask your doctor’s office about signing a HIPAA authorization form that grants them access now.
Changing or Revoking Your Proxy
You can change your health care proxy at any time by completing a new form. The new document automatically replaces the old one, but you should take active steps to avoid confusion. Destroy all copies of the previous form, notify your former proxy that they’ve been replaced, and distribute the updated version to everyone who had a copy of the original: your doctors, your hospital, and your family.
Life changes that commonly prompt an update include divorce (especially if your spouse was your proxy), a falling out with the person you named, your proxy developing their own serious health problems, or a shift in your own values and treatment preferences. There’s no limit to how many times you can update the document.