Colorado: Living Will and Advance Health-Care Instruction Requirements

Colorado calls its living will a Declaration as to Medical or Surgical
Treatment under the Colorado Medical Treatment Decision Act. It states the
adult's own treatment instructions. A medical power of attorney appoints an
agent under a separate act, although § 15-18-104(7) permits both documents
to be combined if every applicable requirement is met.

Requirements one by one

Two witnesses and a notary are alternatives

An adult with decisional capacity executes a written declaration. Under
§ 15-18-106, the adult either signs in the presence of two witnesses or
signs and acknowledges the declaration before a notary or another person
authorized to take acknowledgments. Colorado does not require both routes.

If the adult is physically unable to sign, § 15-18-105 permits another
person to sign in the adult's presence and at the adult's direction. A directed
signer, witness, notary, or acknowledgment officer cannot be the attending or
another physician, an employee of the attending physician or treating facility,
an estate claimant, or a known beneficiary or heir. Article 18 does not impose a
relationship-only or witness-age bar.

The declaration waits for condition and capacity certifications

The declaration addresses a future time when the adult has a terminal condition
or is in a persistent vegetative state and lacks decisional capacity. Under
§ 15-18-107, the attending physician orders an examination by another
physician. Both must find and certify the condition and lack of capacity in
writing, and the declaration and certification enter the hospital record.

If the attending physician knows where to find a listed agent, spouse,
designated beneficiary, adult child, parent, sibling, or other person named in
writing, the physician makes a reasonable effort to notify at least one. The
statute then allows 48 hours after certification for a validity challenge.
Without one, the attending physician follows the declaration.

Nutrition and hydration are a separate written selection

Colorado's § 15-18-103(10) excludes nourishment and comfort or pain measures
from the definition of life-sustaining procedure. Section 15-18-104(3) lets
the adult state separate preferences for life-sustaining procedures and
artificial nutrition and hydration in either covered condition.

For artificial nutrition and hydration, the declaration may direct that it not
continue, continue for a specified period, or continue. If stopping it causes
pain, the attending physician or advanced practice registered nurse may order
continuation to the extent needed for comfort and pain relief.

Article 18 states no pregnancy override

The current §§ 15-18-101 through 15-18-113 contain no pregnancy-specific
suspension, viability test, or option to modify the declaration during
pregnancy. A pregnancy clause imported from another state's form is not a rule
of Colorado's Medical Treatment Decision Act.

Under § 15-18-112(1), Colorado separately preserves medical and nursing standards and
does not authorize euthanasia, mercy killing, or an affirmative or deliberate
act or omission to end life beyond permitting natural death.

Revocation is broader than execution

Under § 15-18-109, the adult may revoke orally, in writing, or by burning,
tearing, canceling, obliterating, or destroying the declaration. The section
does not require two witnesses, a dated writing, delivery to a physician, or a
medical-record notation. Actual notice still matters to provider protection:
§ 15-18-110 permits reliance only in the absence of actual notice of
revocation, fraud, misrepresentation, or improper execution.

Colorado also has an optional statewide electronic storage system. Under
§§ 25-54-101 and 25-54-102, a participating provider may upload the
declaration at the adult's request after an in-person or telehealth consultation
and a provider-present electronic affidavit confirming the document is properly
executed, current, and accurate. That affidavit revokes same-type directives
previously uploaded; registration is not an execution formality.

Refusal requires transfer, and validity may be challenged

The family members and representatives listed in § 15-18-108 may challenge
validity in court. Filing the petition and notifying the attending physician
produces a temporary restraining order until the court decides validity.

A physician or advanced practice registered nurse who refuses a facially valid
declaration must transfer care to a willing professional under § 15-18-113;
refusal plus failure to transfer is professional misconduct or grounds for
discipline. Good-faith compliance receives the protections in § 15-18-110.
Colorado treats a declaration valid where executed as effective unless it
violates Colorado law (§ 15-18-108(6)).

What trips people up

• Choose witnesses or acknowledgment. Two witnesses plus a notary is not
  Colorado's requirement; either statutory route works.
• Relatives are not automatically barred. A relative is disqualified only
  if another § 15-18-105 category applies, such as known inheritance rights.
• The 48 hours follows medical certification. It is a period for a validity
  challenge, not a waiting period before the adult signs.
• Oral revocation needs none of the signing formalities. Section 15-18-109
  does not carry the witnesses-or-notary rule into revocation.

Common questions

Does a Colorado living will have to be notarized?

No. The adult may instead sign before two qualified witnesses (§ 15-18-106).

May someone else sign for me?

Yes, if you are physically unable to sign. The person must sign in your presence
and at your direction and must not fall within § 15-18-105's barred categories.

Is the statewide electronic system required?

No. It stores a properly executed directive; it does not replace the witnesses
or acknowledgment required by § 15-18-106.

Will Colorado honor a living will signed elsewhere?

Yes. Section 15-18-108(6) recognizes a declaration compliant with the execution
state's law to the extent it does not violate Colorado law.

Statutes and sources

• Colo. Rev. Stat. §§ 15-18-101 through 15-18-104 — Act, definitions,
  capacity, conditions, separate treatment and nutrition choices, comfort, and
  combined documents. Official Title 15 PDF
  (accessed 2026-07-31).
• Colo. Rev. Stat. §§ 15-18-105 through 15-18-108 — directed signature,
  witnesses or acknowledgment, certifications, 48-hour period, challenge, and
  out-of-state effect. Official Title 15 PDF
  (accessed 2026-07-31).
• Colo. Rev. Stat. §§ 15-18-109 through 15-18-113 — revocation, immunity,
  medical standards, natural-death boundary, refusal, and transfer. Official
  Title 15 PDF (accessed 2026-07-31).
• Colo. Rev. Stat. §§ 25-54-101 and 25-54-102 — optional statewide
  electronic storage, upload affidavit, and effect on earlier uploaded copies.
  Official Title 25 PDF (accessed
  2026-07-31).