California: Health Care Power of Attorney Requirements

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: your "health care provider or an employee of [your]
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 2026-07-16)