What is a California Advance Health Care Directive?

An Advance Health Care Directive is the California legal document (Probate Code §4670 et seq.) that combines (a) a healthcare power of attorney designating someone to make medical decisions on your behalf if you cannot, and (b) instructions for end-of-life and life-sustaining treatment decisions. It replaces the older 'living will' and 'durable power of attorney for healthcare' as separate documents.

Does a Health Care Directive need to be notarized in California?

It needs EITHER notarization OR two qualifying adult witnesses (not both). If the signer lives in a skilled nursing facility, an additional patient-advocate witness is required regardless. Notarization is cleaner because it eliminates witness-disqualification disputes.

Can a healthcare directive be signed at a hospital?

Yes, very commonly. Hospital bedside notarization for advance directives is one of our most-requested services. The signer must still be aware, oriented, and able to understand the document. If the signer's capacity is in any doubt, the notary cannot proceed.

Advance Health Care Directive Notarization

Mobile notarization of the California Advance Health Care Directive (AHCD) at home, hospital, or care facility. The AHCD combines a healthcare power of attorney with your instructions for end-of-life and life-sustaining treatment — the single most important document many adults will ever sign. Sacramento Probate Code §4670 compliant. Average response: 22 minutes.

Per signature

$15 max

Hospital visits

Yes

Authority

PC §4670

After-hours

24 / 7

What's in a California Advance Health Care Directive

The AHCD (introduced by the Health Care Decisions Law of 2000) is California's unified end-of-life planning instrument. It consists of four parts:

Part 1 — Healthcare Power of Attorney. Designates your "agent" who can make healthcare decisions for you if you cannot. You can also name alternates.
Part 2 — Individual Instructions. Your direction on whether to prolong life with artificial nutrition, hydration, mechanical ventilation, dialysis, etc., and under what circumstances to allow natural death.
Part 3 — Anatomical gift / donor instructions. Whether and what to donate after death.
Part 4 — Primary physician designation. Optional naming of your primary care physician.

You don't have to complete every part — the form is À la carte. Many signers complete only Part 1 (healthcare agent), some complete all four.

Execution requirements (notarization vs witnesses)

California Probate Code §4673 sets the execution requirements. The AHCD requires either:

(a) A notary acknowledgment, OR
(b) Two qualifying adult witnesses who sign in the principal's presence.

You do not need both. The witness route is cheaper but introduces complications: the witnesses cannot be the named healthcare agent, cannot be related to the principal by blood/marriage/adoption, cannot be the operator or employee of a healthcare facility where the principal is a patient, and cannot have a claim against the principal's estate. The notary route eliminates all of these disqualifications — the notary need only be a California-commissioned notary unrelated to the document.

Skilled nursing facility exception

If the principal is a patient in a skilled nursing facility (SNF) at the time of signing, Probate Code §4675 requires an additional witness: a patient advocate or ombudsman, regardless of whether the AHCD is being notarized or witnessed. The California Department of Aging provides ombudsman services free of charge; we can help coordinate.

POLST is different (and not notarized)

The Physician Orders for Life-Sustaining Treatment (POLST) form is a separate, complementary document. It's signed by the patient (or surrogate) AND the patient's physician, and translates the patient's wishes into immediate medical orders. POLST is not a notary instrument — we don't notarize it. It works alongside the AHCD: the AHCD names who decides and what's preferred; the POLST converts those preferences into orders the EMTs and hospital must follow.

Hospital and care-facility bedside notarization

We routinely visit:

Sutter — Sacramento, Roseville, Davis, Fairfield
Kaiser Permanente — Roseville, South Sacramento, Sacramento
Mercy / Dignity Health — Mercy General, Mercy San Juan, Mercy Folsom, Methodist
UC Davis Health — Sacramento main campus, the trauma center
Adventist Health Lodi Memorial and others outside the immediate metro
Care facilities — Eskaton, Atria, Carlton, Brookdale, Sunrise, Pacifica

See our dedicated hospital notary services page for facility-specific protocols and what to expect at intake.

Capacity requirement

California notary law (Government Code §8214.1(c)) prohibits notarization when the signer "is unable to communicate, by any means" or appears not to understand the act being performed. For healthcare directives, we follow a brief capacity confirmation:

Can the signer state their name and approximate date?
Can the signer state what document we're signing and what it does?
Can the signer state who they're naming as agent and why?

If the signer cannot answer these questions in their own words, we cannot proceed. This is not negotiable — even if family is present and urging us to sign anyway. The right path then is a court-appointed conservator, or revisiting the document when the signer's capacity has stabilized (which sometimes happens with reversible conditions).

Common questions

What's the difference between a healthcare directive and a living will?

In California, the AHCD replaced both the older "living will" and the "durable power of attorney for healthcare" by combining them into one document. If you have older versions on file, they're still typically valid, but a new AHCD supersedes them. Other states still use separate "living will" documents.

Can I change my directive later?

Yes — you can revoke or amend at any time while you have capacity. Verbal revocation is sufficient if communicated to a healthcare provider, though written revocation is cleaner. To update, simply execute a new AHCD; the new one supersedes the old.

Do I need to give a copy to my doctor?

Yes — an AHCD is only useful if your healthcare providers know it exists. Give copies to your primary care physician, your named agent and alternates, and (if you're admitted to a hospital) the admitting facility. Many hospitals scan AHCDs into the patient's electronic record on admission.

Should I have it drafted by an attorney?

Not required. The California Probate Code includes a statutory form (you can find it at §4701) that's free, valid, and easy to complete. Attorney drafting is recommended only for complex situations — blended families, contested family dynamics, or specific religious/cultural directives.

Request an AHCD notarization

Home, hospital, or care facility. Same-day and after-hours available.

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