Free Massachusetts Advance Directive Form (Medical POA & Living Will) | PDF

Massachusetts Advance Directive Form (Medical POA & Living Will)

The Massachusetts Advance Directive is a two-part document that provides doctors and family members with the executor’s instructions concerning medical treatment at the time of their incapacity. To complete the document, users must name an agent, indicate their preferences, and sign it before two (2) witnesses.

Last updated September 24th, 2024

The Massachusetts Advance Directive is a two-part document that provides doctors and family members with the executor’s instructions concerning medical treatment at the time of their incapacity. To complete the document, users must name an agent, indicate their preferences, and sign it before two (2) witnesses.

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Advance Directive

This Document Contains:

(Individuals seeking to register as organ/tissue donors may do so by visiting the Donate Life New England Website and providing the requested information.)

Laws

Statutes – Medical POA (Chapter 201D: Health Care Proxies), Living Will (No Legal Statutes)

Definition – ”Health care proxy”, a document delegating to an agent the authority to make health care decisions, executed in accordance with the requirements of this chapter (201D § 1). Massachusetts law does not contain a legal definition for the living will document.

Signing Requirements – The health care proxy section of the advance directive must be signed in the presence of two (2) witnesses (201D § 2). Although there are no legal signing requirements regarding the living will portion, it is recommended that the principal sign it as confirmation of their recorded wishes.

Other Versions (8)

AARP
Archdiocese of Boston
Beth Israel Deaconess Medical Center
Brigham and Women’s Hospital
Five Wishes (Aging with Dignity)
Honoring Choices Massachusetts
Massachusetts Catholic Conference
Prepare for Your Care

AARP Version

Download: Adobe PDF
Instructions: Adobe PDF

Archdiocese of Boston Version

Download: Adobe PDF

Beth Israel Deaconess Medical Center Version

Download: Adobe PDF

Brigham and Women’s Hospital Version

Download: Adobe PDF
Information: Adobe PDF

Five Wishes (Aging with Dignity) Version

Download: Adobe PDF
Information: Adobe PDF

Honoring Choices Massachusetts Version

Download: Adobe PDF

Massachusetts Catholic Conference Version

Download: Adobe PDF

Prepare for Your Care Version

Download: Adobe PDF
Languages: Chinese, Spanish

Multilingual Versions (4)

Portuguese
Russian
Spanish/Español
Traditional Chinese

Portuguese Version

Download: Adobe PDF

Russian Version

Download: Adobe PDF

Spanish/Español Version

Download: Adobe PDF

Traditional Chinese Version

Download: Adobe PDF

Additional Resources

Department of Public Health – Know Your Choices (Spanish/Español)
Honoring Choices Massachusetts – Choosing a Health Care Agent
Honoring Choices Massachusetts – Next Steps Tool Kit
Honoring Choices Massachusetts – Things to Know About a Health Care Proxy
Honoring Choices Massachusetts – Things to Know About a Personal Directive
Honoring Choices Massachusetts – Things to Know About Life-Sustaining Treatment
Honoring Choices Massachusetts – Things to Know About MOLST & CC/DNR Orders
Honoring Choices Massachusetts – Who’s Your Agent?
Massachusetts Medical Society – Planning Ahead Brochure (Spanish/Español)
Massachusetts MOLST – Brochure (Spanish/Español)
Massachusetts MOLST – Glossary of Terms (Spanish/Español)
Mental Health Legal Advisors Committee – Practical Guide to DNR Orders
State of Massachusetts – Children with CC/DNR Orders in a School Setting
Tufts Health Plan – Types of Advance Directives for Massachusetts

Related Forms

Comfort Care DNR Order Verification with Bracelet Inserts

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Durable (Financial) Power of Attorney

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Medical Orders for Life-Sustaining Treatment (MOLST) Form

Download: Adobe PDF, MS Word (.docx)
Information: Adobe PDF

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