Tennessee: Health Care Power of Attorney Requirements

Tennessee uses one advance directive for health care that can do two jobs:
appoint a health care agent and record treatment instructions. The agent-
appointment portion is the state's health care power of attorney. The rules are
in the Tennessee Health Care Decisions Act, Tenn. Code §§ 68-11-1801 through
68-11-1816. The Health Facilities Commission publishes an optional model form
under § 68-11-1805, and its parts may be used together or independently.

Requirements one by one

An adult or emancipated minor signs a written directive

Section 68-11-1803(b) allows an adult or emancipated minor to execute the
directive. It must be "in writing and signed by the principal." Capacity means
the ability to understand the significant benefits, risks, and alternatives to
the proposed care and to make and communicate a decision (§ 68-11-1802(3)).
Section 68-11-1812 presumes that the person has capacity (§ 68-11-1812).

Choose a notary or two qualified witnesses

The signing paths are alternatives. Section 68-11-1803(b) says the directive
"must either be notarized or witnessed by two (2) witnesses." If two witnesses
are used, both must be competent adults and neither may be the appointed agent.
At least one must be unrelated by blood, marriage, or adoption and not entitled
to inherit from the principal. The document also needs an attestation clause
confirming those qualifications.

The second witness may be a relative or possible heir so long as the other
witness satisfies the disinterested-witness rule. The statute does not require
both witnesses to be unrelated.

The provider and facility-employee restrictions in § 68-11-1806(g) apply to a
surrogate selected when no agent can act. They are not additional
disqualifications for the agent deliberately appointed in the directive.

Agent authority is springing unless the document says otherwise

By default, the agent's authority begins when the designated physician
determines that the principal lacks capacity and ends if capacity returns
(§ 68-11-1803(c)–(d)). The directive may change that default. Tennessee's
official model form therefore offers a choice between immediate authority and
authority only after the signer loses capacity.

The agent follows known wishes, then best interests

The directive may authorize the agent to make any health care decision the
principal could have made while capable (§ 68-11-1803(b)). The agent first
follows the principal's instructions and other known wishes. If those do not
answer the question, the agent decides according to the principal's best
interests while considering known personal values. The decision is effective
without court approval (§ 68-11-1803(e)–(f)).

Revoking the agent is more formal than changing treatment wishes

Section 68-11-1804 draws a sharp line. A person with capacity may revoke the
agent designation only through a signed writing or by personally informing
the supervising health care provider. Other parts of the directive may be
revoked in any manner communicating intent. A later conflicting directive
revokes the earlier one to the extent of the conflict.

An annulment, divorce, dissolution, or legal separation revokes a spouse-agent
unless the decree or the directive says otherwise (§ 68-11-1804(c)).

The out-of-state rule is limited to nonresidents

Tennessee honors a directive executed outside Tennessee when the signer was not
a Tennessee resident at the time and the directive complied either with the
Tennessee Act or the law of the signer's state of residence
(§ 68-11-1803(h)). The statute does not state the same safe harbor for a
Tennessee resident who signs elsewhere.

What trips people up

• Your agent cannot witness the document. Use two other competent adults if
  you choose witnesses (§ 68-11-1803(b)).
• Only one witness has to be disinterested. A form demanding that both
  witnesses be unrelated and unable to inherit is stricter than the statute.
• Immediate authority is not the default. The official form has a separate
  choice for authority "at any time"; without contrary language, the statutory
  default waits for the designated physician's incapacity finding.
• Telling a family member does not revoke the agent appointment. Use a signed
  writing or personally inform the supervising provider (§ 68-11-1804(a)).

Common questions

Does an agent need a court order before making a decision?

No. Section 68-11-1803(f) says an agent's health care decision is effective
without judicial approval.

Can the directive nominate a guardian too?

Yes. Section 68-11-1803(g) expressly allows the directive to include a nomination
of a guardian of the person.

Is an older Tennessee living will automatically useless?

No. Section 68-11-1803(j) preserves qualifying older living wills and durable
health care powers under their respective statutes and tells providers to give
them effect under those laws.

Statutes and sources

• Tenn. Code §§ 68-11-1802 to -1805 and -1812. Definitions, execution,
  witness/notary alternatives, timing, authority, out-of-state recognition,
  revocation, model forms, and capacity presumption. These provisions were
  enacted in Public Chapter 862 and later codified in Part 18.
  Official enacted Act
  (accessed July 17, 2026).
• 2014 Tenn. Pub. Ch. 676. The only enacted amendment found to
  § 68-11-1803; it replaces subsection (i), which concerns conditioning care or
  insurance on an advance directive and does not alter this page's execution or
  agent rules.
  Official chapter
  (accessed July 17, 2026).
• Tennessee Advance Directive for Health Care. Current official model form,
  including the immediate/springing election and the notary-or-two-witness
  execution blocks.
  Official form
  (accessed July 17, 2026).