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Definition – “Proxy directive” means a writing which designates a health care representative in the event the declarant subsequently lacks decision-making capacity (§ 26-2H-55).
Signing Requirements – Review and attestation from two (2) subscribing witnesses or a notary is necessary (§ 26-2H-56).
Revocation – § 26-2H-57
Other Versions
New Jersey Medical Power of Attorney Form – Version 1
Download: Adobe PDF
Additional Resources
- Cooper University Health Care – Advance Directives and Living Wills
- Middlesex County Govt. Website – What is an Advance Directive for Health Care?
- NJ Health Care Quality Institute – Conversations of Your Life Brochure (also available in Spanish/en Español)
- State of New Jersey Dept. of Health – Frequently Asked Questions
- State of New Jersey Dept. of Health – POLST Brochure
Related Forms (4)
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- POLST Form
- Psychiatric Advance Directive
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Practitioners Orders for Life-Sustaining Treatment (POLST) (also available in Spanish/en Español)
Download: Adobe PDF
Psychiatric Advance Directive (also available in Spanish/en Español)
Download: Adobe PDF
Instructions/Information: Adobe PDF
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