Virginia: Health Care Power of Attorney Requirements

Virginia packages the health care power of attorney inside a single document
called an advance directive. One form can appoint an agent to make your
medical decisions, record your own treatment wishes (the "living will" part), or
both — you choose which options to fill in. The rules are in the Health Care
Decisions Act, Va. Code Title 54.1, Chapter 29, Article 8 (§§ 54.1-2981 to
54.1-2995). This page covers the part that appoints an agent.

Requirements one by one

Governing law and document

There is one instrument. Under § 54.1-2983, a written advance directive
"may ... appoint an agent to make health care decisions for the declarant" and
may also specify the care you do or do not want. Virginia publishes a suggested
combined form at § 54.1-2984, but it is optional: an advance directive
"may, but need not, be in the following form."

Who can sign

The signer — the "declarant" — must be "an adult who makes an advance directive
... while capable of making and communicating an informed decision" (§ 54.1-2982).
Section 54.1-2983 lets "any adult capable of making an informed decision" make a
written directive "at any time."

Witnesses or notary

Virginia keeps this simple: two witnesses, no notary. Section 54.1-2983
provides that a written advance directive "shall be signed by the declarant in
the presence of two subscribing witnesses." Nothing in the execution rule
requires a notary public. (A notary appears in the statute only in one narrow
place — removing a directive you filed with the state's Advance Health Care
Planning Registry — and never as a condition of signing.)

Who can't witness or serve

This is where Virginia is a genuine outlier. Most states bar relatives, heirs,
and care providers from witnessing; Virginia bars almost no one. Section
54.1-2982 defines a "witness" as "any person over the age of 18, including a
spouse or blood relative of the declarant," and adds that "[e]mployees of
health care facilities and physician's offices, who act in good faith, shall be
permitted to serve as witnesses." So your spouse and your adult child can be your
two witnesses, and a nurse at your hospital can sign too. As for the agent,
the only statutory requirement is that the person be an adult (§ 54.1-2982); the
Act sets no further list of who may not serve.

When the agent can act

The power is springing. Under § 54.1-2986.1, an appointed agent has authority
"if the declarant is determined to be incapable of making an informed decision,"
and that determination is demanding. Section 54.1-2983.2 presumes every adult
capable, and — before an agent may act — requires the attending physician to
certify in writing, after a personal examination, that you are incapable of
making an informed decision, plus a separate written certification from an
independent "capacity reviewer" (a physician or clinical psychologist). The
capacity-reviewer step is waived only if you are unconscious or profoundly
impaired. The determination must be revisited at least every 180 days.

Agent's powers and limits

Once the power is in effect, the agent makes the decisions the directive gives
them and outranks the default-surrogate list in § 54.1-2986 (§ 54.1-2986.1). The
suggested form in § 54.1-2984 shows how broad those powers can be: the agent may
"consent to or refuse or withdraw consent to any type of health care," expressly
including "artificially administered nutrition and hydration, and cardiopulmonary
resuscitation." Virginia does not hand every agent a fixed list of forbidden
acts; instead it builds in two safeguards. Admission to a mental-health
facility is limited — the form authorizes at most 10 days and only with a
physician's written finding and specific authorization (§§ 54.1-2984,
54.1-2983.2). And under § 54.1-2986.1, the agent must make a good-faith effort to
follow your religious values, basic values, and known preferences, not the
agent's own.

How to revoke

While you can still understand the consequences, you may revoke "at any time"
(§ 54.1-2985 A): by a signed, dated writing, by destroying the document (or
having someone destroy it in your presence), or simply by an "oral expression of
intent to revoke." A revocation "shall be effective when communicated to the
attending physician." Virginia also revokes an agent's authority automatically on
the filing of a divorce or annulment action — or even a custody or visitation
petition — between you and the agent (§ 54.1-2985 A1).

Out-of-state directives

Section 54.1-2993 recognizes directives from elsewhere: "[a]n advance directive
executed in another state shall be deemed to be validly executed for the purposes
of this article if executed in compliance with the laws of the Commonwealth of
Virginia or the laws of the state where executed," and it will be "construed in
accordance with the laws of the Commonwealth of Virginia."

What trips people up

• No notary is required — two witnesses are enough. People often assume a
  medical directive must be notarized. In Virginia the execution rule is only
  "two subscribing witnesses" (§ 54.1-2983); a notary is never a condition of
  validity.
• Your relatives can witness it. Unlike most states, Virginia lets a spouse
  or blood relative serve as a witness, and even good-faith facility and
  physician-office staff (§ 54.1-2982). Two family members can validly witness
  your directive.
• The agent's authority needs two doctors, usually. Before your agent can
  act, the attending physician must certify your incapacity in writing and an
  independent capacity reviewer must confirm it — unless you are unconscious
  (§ 54.1-2983.2). A single doctor's note is generally not enough.
• Filing for divorce — or even a custody petition — cancels a spouse-agent.
  Section 54.1-2985 A1 revokes the agent's authority the moment such an action is
  filed, not when the divorce is final. Name a successor agent if you want a
  backup.
• Mental-health admission has its own limits. An agent's power to admit you
  to a mental-health facility is capped at 10 days and requires specific
  authorization plus a physician's finding (§§ 54.1-2984, 54.1-2983.2); it is not
  automatic even under a broad grant.

Common questions

Does a Virginia advance directive have to be notarized?
No. It only has to be signed in the presence of two witnesses (§ 54.1-2983). A
notary is optional and is not part of the validity rule.

Can my spouse or child be a witness?
Yes. Virginia's definition of a witness expressly includes "a spouse or blood
relative" of the declarant, and good-faith facility employees may serve too
(§ 54.1-2982). This is broader than most states allow.

When does my agent's authority start?
Only after you are determined "incapable of making an informed decision" — which
normally takes your attending physician's written certification plus an
independent capacity reviewer's certification (§ 54.1-2983.2). Until then, you
decide for yourself.

Will the directive I signed in another state work in Virginia?
Yes, if it was validly executed under that state's law (or Virginia's). Section
54.1-2993 treats it as validly executed and construes it under Virginia law.

Statutes and sources

• Va. Code § 54.1-2982 — definitions of "agent," "declarant," and "witness"
  (spouse, blood relative, and good-faith facility staff may witness).
  https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2982/ (accessed 2026-07-16)
• Va. Code § 54.1-2983 — a written advance directive is signed before two
  subscribing witnesses and may appoint an agent.
  https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2983/ (accessed 2026-07-16)
• Va. Code § 54.1-2983.2 — capacity determination: attending physician plus an
  independent capacity reviewer, unless the patient is unconscious.
  https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2983.2/ (accessed 2026-07-16)
• Va. Code § 54.1-2984 — suggested combined form and the scope of the agent's
  powers, including the 10-day mental-health-admission limit.
  https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/ (accessed 2026-07-16)
• Va. Code § 54.1-2985 — revocation methods and automatic revocation of a
  spouse-agent on a divorce, annulment, custody, or visitation filing.
  https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2985/ (accessed 2026-07-16)
• Va. Code § 54.1-2986.1 — the agent's authority, priority over default
  surrogates, and good-faith duties.
  https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2986.1/ (accessed 2026-07-16)
• Va. Code § 54.1-2993 — reciprocity for a directive executed in another
  state.
  https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2993/ (accessed 2026-07-16)