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Definitions – “Health care power of attorney” means a written designation of an agent to make health care decisions that meets the requirements of section 36-3221 and that comes into effect and is durable as provided in section 36-3223, subsection A (§ 36.3201(6)).
Signing Requirements – The primary party conveying the powers must sign the instrument under the supervision of a notary public or witness (§ 36-3221(3)).
Revocation – § 36.3202
Other Versions (3)
America Living Will Registry Version
Download: Adobe PDF
Dignity Health Version (also available in Spanish/en Español)
Download: Adobe PDF
Download: Adobe PDF
Additional Resources
- Arizona Dept. of Economic Security – Decisions About Your Health Care Guide
- Arizona Hospital and Healthcare Association – Advance Care Planning
- Health Current – Arizona Healthcare Directives Registry
- Hospice of the Valley – Health Care Decisions FAQs
Related Forms (5)
- Advance Directive
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- Health Care Directive Registration Agreement
- Health Care Power of Attorney for a Minor
Download: Adobe PDF
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF
Health Care Directive Registration Agreement
Download: Adobe PDF
Health Care Power of Attorney for a Minor
Download: Adobe PDF
Information: Adobe PDF
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