Health Care Power of Attorney Requirements in California

At a glance

California folds the health care power of attorney into a single document called an advance health care directive. Part 1 of that directive appoints your agent (the health care power of attorney); Part 2, which you can leave blank, is the "living will" where you record treatment wishes. This page is about executing Part 1 — naming someone to make medical decisions for you. The rules live in the Health Care Decisions Law, California's version of the Uniform Health Care Decisions Act, at Probate Code §§ 4670–4701.

Requirements one by one

Governing law and document

There is one instrument, not two. Under § 4671, "[a]n adult having capacity may execute a power of attorney for health care," and that power of attorney "may authorize the agent to make health care decisions and may also include individual health care instructions." So the agent appointment and the living will are two parts of the same directive. California publishes an optional statutory form at § 4701 — the widely used "Advance Health Care Directive" — but the form is not mandatory; the statute expressly tells the signer, "You are free to use a different form."

Who can sign

The signer must be an adult with capacity (§ 4671). The directive itself must, under § 4673(a), contain "the date of its execution" and be "signed either by the patient or in the patient's name by another adult in the patient's presence and at the patient's direction." That last clause is what lets someone who cannot physically hold a pen still execute a directive: another adult signs the patient's name, but only while the patient is present and only at the patient's direction.

Witnesses or notary

This is the step people most often get wrong. Section 4673(a)(3) gives you a choice: the directive is sufficient if it "is either acknowledged before a notary public or signed by at least two witnesses." You do not need both. Two qualified witnesses and a notary are interchangeable ways to validate the same document.

One important exception: an electronic directive removes the choice. Under § 4673(b), an electronic advance health care directive "shall" be acknowledged before a notary public — the two-witness option is not available for a digital document, which must also carry a qualifying digital signature.

Who can't witness or serve

If you use witnesses, they must be adults, and § 4674(c) disqualifies four categories from serving: "The patient's health care provider or an employee of the patient's health care provider," the "operator or an employee of a community care facility," the "operator or an employee of a residential care facility for the elderly," and "[t]he agent" you are naming. On top of that, § 4674(e) requires that "[a]t least one of the witnesses" be someone "neither related to the patient by blood, marriage, or adoption, nor entitled to any portion of the patient's estate." A notary, if you use one instead, is not subject to these witness rules (§ 4674(g)).

The statutory form adds the parallel limit on who may serve as agent: your agent may not be your supervising health care provider, or an operator or employee of a community care or residential care facility where you are getting care, "unless your agent is related to you or is a coworker" (§ 4701).

When the agent can act

By default the power is springing. Section 4682 provides that "[u]nless otherwise provided in a power of attorney for health care, the authority of an agent becomes effective only on a determination that the principal lacks capacity, and ceases to be effective on a determination that the principal has recovered capacity." The statutory form makes that determination the job of your "primary physician," and it gives you a box to check if you instead want your agent to act immediately, even while you still have capacity (§ 4701).

Agent's powers and limits

Once the power is in effect, § 4683 gives your agent authority to "make health care decisions for the principal to the same extent the principal could make health care decisions" — subject to any limits you write into the document. But some decisions are off the table for every agent. The statutory form states that your agent "will not be able to commit you to a mental health facility, or consent to convulsive treatment, psychosurgery, sterilization, or abortion for you" (§ 4701). Those limits apply no matter what the document says.

How to revoke

California treats the agent designation more formally than the rest of the directive. Under § 4695(a), you may revoke the designation of an agent "only by a signed writing or by personally informing the supervising health care provider." Everything else in the directive — your treatment instructions — you may revoke "at any time and in any manner that communicates an intent to revoke" (§ 4695(b)). Separately, § 4697 automatically revokes a spouse-agent if your marriage to that agent is "dissolved or annulled" (and revives the designation if you remarry that person).

Out-of-state directives

If you signed a directive in another state and later need care in California, § 4676 honors it: a directive "executed in another state or jurisdiction in compliance with the laws of that state or jurisdiction or of this state, is valid and enforceable in this state to the same extent as a written advance directive validly executed in this state."

What trips people up

• You do not need a notary if you have two witnesses. Many people assume a health care directive must be notarized. In California it is one option, not a requirement — two qualified witnesses do the same job (§ 4673(a)(3)). The exception is a fully electronic directive, which must be notarized (§ 4673(b)).
• A relative can witness, but not alone. A family member may be one of your two witnesses, but at least one witness must be someone unrelated to you and not in line to inherit (§ 4674(e)). Using two relatives invalidates the witness path.
• Your doctor and your facility's staff are barred as witnesses and (usually) as agent. The treating provider, their employees, and the operators and employees of a community care or residential care facility are disqualified as witnesses (§ 4674(c)) and generally cannot serve as agent unless related to you or a coworker (§ 4701).
• A skilled nursing facility adds a witness. If you sign while a patient in a skilled nursing facility, the directive "is not effective" unless a patient advocate or ombudsman also signs as a witness (§ 4675) — an extra safeguard on top of the usual notary-or-two-witnesses rule.
• Divorce quietly cancels a spouse-agent. If you named your spouse and later divorce, that appointment is revoked by operation of law (§ 4697). If you still want that person to decide for you, you must sign a new directive.

Common questions

Does a California health care directive have to be notarized? No. You can either have it notarized or have two qualified witnesses sign it — your choice (§ 4673(a)(3)). Only an electronic directive must be notarized.

Can my agent make decisions for me right now, before I lose capacity? Only if you say so. By default your agent can act only after a physician determines you cannot make your own decisions (§ 4682), but the statutory form lets you check a box to make the authority effective immediately (§ 4701).

Will the directive I signed in another state work in California? Yes, if it was validly executed under that state's law (or California's). California recognizes it "to the same extent" as a California directive (§ 4676).

How do I cancel the agent I named? Put it in a signed writing, or tell your supervising health care provider in person (§ 4695(a)). Simply telling a friend is not enough to revoke the agent designation, though it can revoke your treatment instructions (§ 4695(b)).

Statutes and sources

• Cal. Prob. Code § 4671 — an adult with capacity may execute a power of attorney for health care. https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=PROB&division=4.7.&title=&part=2.&chapter=1.&article=1. (accessed 2026-07-16)
• Cal. Prob. Code § 4673 — execution: dated, signed by or at the patient's direction, and either notarized or signed by two witnesses; electronic directive must be notarized. (same Article 1 page; accessed 2026-07-16)
• Cal. Prob. Code § 4674 — witness qualifications and disqualifications; at least one unrelated, non-heir witness. (same Article 1 page; accessed 2026-07-16)
• Cal. Prob. Code § 4675 — skilled-nursing-facility patient advocate or ombudsman witness. (same Article 1 page; accessed 2026-07-16)
• Cal. Prob. Code § 4676 — recognition of an out-of-state directive. (same Article 1 page; accessed 2026-07-16)
• Cal. Prob. Code § 4682 — default springing effect on determination of incapacity. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB&sectionNum=4682. (accessed 2026-07-16)
• Cal. Prob. Code § 4683 — agent's authority equal to the principal's, subject to stated limits. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB&sectionNum=4683. (accessed 2026-07-16)
• Cal. Prob. Code § 4695 — revocation of the agent (signed writing or notice to provider) and of instructions (any manner). https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB&sectionNum=4695. (accessed 2026-07-16)
• Cal. Prob. Code § 4697 — dissolution or annulment revokes a spouse-agent. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB&sectionNum=4697. (accessed 2026-07-16)
• Cal. Prob. Code § 4701 — optional statutory advance-directive form, including the "two qualified witnesses or acknowledged before a notary public" execution line and the limits on agent authority. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB&sectionNum=4701. (accessed 2026-08-08)