How to Fill Out and Register Your Louisiana Advance Directive Form

The Louisiana advance directive form is actually two documents: a living will declaration that tells doctors when to withhold life-sustaining treatment, and a healthcare power of attorney that names someone to make medical decisions if you can’t. You can download the declaration from the Louisiana Secretary of State’s website, and both forms appear together in the Governor’s Office of Elderly Affairs self-help guide.¹ Fill them out, sign in front of two qualified witnesses, give copies to the people who need them, and — if you want — pay $20 to put the declaration in the state registry.

The Two Documents and What Each One Does

The living will declaration is your direct instruction to physicians. It authorizes them to withhold or withdraw life-sustaining procedures if you develop a terminal and irreversible condition, defined under Louisiana law as either a continual profound comatose state with no reasonable chance of recovery, or an injury or illness where continued treatment would only delay death. Comfort care and pain management continue regardless of what your declaration says.²

The healthcare power of attorney (HCPOA) is broader. It names an agent who can consent to or refuse treatments, authorize hospital admissions and discharges, sign contracts for medical services, and make decisions about surgery and medication once you’re unable to make them yourself. You have to sign it while competent, and it stays effective after you become incapacitated.³

Most people complete both. The declaration speaks for you about end-of-life treatment specifically; the HCPOA gives a real person authority to handle everything else that comes up.

Filling Out the Living Will Declaration

The declaration is essentially a single page. You enter your name, state that you’re of sound mind, and declare that if you develop a terminal and irreversible condition, your physician should withhold or withdraw life-sustaining procedures. The one real decision point is whether artificial nutrition and hydration — tube feeding and IV fluids — should be treated the same as other life-sustaining procedures or excluded from the directive. Decide that before you sign.

Louisiana law treats the statutory form as illustrative rather than mandatory. A declaration can be made in writing, orally, or through nonverbal communication.² Using the standard form avoids ambiguity and makes it easier for hospitals to recognize and follow.

Filling Out the Healthcare Power of Attorney

Before you sit down with the HCPOA, gather the following for your chosen agent and at least one alternate:

Full legal name
Home address
Home, work, and cell phone numbers

The alternate matters more than people think. If your primary agent is traveling, hospitalized, or unreachable, the alternate steps in. Without one, your family may have to work through the statutory priority list of people who can consent to treatment on your behalf, which adds delay and room for disagreement.⁴

The form then walks you through five categories of authority, each with a separate “I DO / I DO NOT” choice so your agent only gets the powers you specifically grant:

General treatment decisions — consenting to or refusing any healthcare service, treatment, or procedure, even if death may result.
Facility admissions — authorizing admission to or discharge from a hospital, nursing home, or assisted living facility.
Financial contracts — signing contracts for healthcare services and facilities on your behalf, without the agent becoming personally liable.
Surgery, expenses, and prescriptions — making decisions about surgical procedures, medical costs, and medications.
Visitation — preventing or allowing visits and communication from specific people you name on the form.

The form includes a HIPAA authorization section letting your agent access your medical records and speak with your providers. There’s also a blank for special provisions where you can list treatments you specifically want or want to avoid.³

Signing It Correctly

This is where most forms fail. A document that isn’t properly witnessed has no legal force.

The declaration must be signed in the presence of two witnesses.⁵ A valid witness is a competent adult who is not related to you by blood or marriage and who would not be entitled to any portion of your estate upon your death.⁶ That rules out your spouse, children, siblings, and anyone named in your will. A neighbor, coworker, or friend with no stake in your estate is the safest choice.

The HCPOA also needs two witnesses, each at least 18 years old, not related to you by blood, marriage, or adoption, and not named in your will. Notarization isn’t legally required in Louisiana, but having the HCPOA notarized helps with out-of-state providers and heads off later challenges to its authenticity.³

Registering the Declaration With the Secretary of State

Louisiana runs a voluntary Living Will Registry. Registration costs $20 and includes a laminated identification card and an ID bracelet, both of which alert emergency responders that your directive is on file.¹

Mail the original declaration (or a certified copy) with the $20 fee to:

Secretary of State
Attn: Elections Services
P.O. Box 94125
Baton Rouge, LA 70804-9125

An attorney can submit it on your behalf if you authorize it. Registration puts your declaration in a statewide system, but it doesn’t replace getting copies into the hands of the people who will actually use them.

Who Should Get a Copy

Give copies to:

Your primary care physician, so it goes in your chart.
Your healthcare agent and any alternate.
Your local hospital, so it’s in your electronic medical record before an emergency.
Close family members who might be involved in your care.

Keep the original in a secure but accessible place at home. A fireproof folder works. A locked safe deposit box is a poor choice — your agent may not have access, and banks aren’t open during weekend emergencies.

Changing or Revoking It Later

You can revoke your declaration at any time, regardless of your mental state, using any of three methods:⁷

Destroy the document yourself, or have someone destroy it in your presence and at your direction.
Sign and date a written statement expressing your intent to revoke.
Communicate your intent orally or nonverbally to your attending physician.

Revocation takes effect the moment your physician receives notice, and the physician records the date and time in your medical record. If you registered the declaration, file a separate written notice of revocation with the Secretary of State as well, since providers checking the registry may otherwise still rely on the original in good faith.⁷

To change rather than cancel the directive, the simplest route is to execute a new one. Amending an existing document requires the same witness formalities as a brand-new directive, so starting fresh avoids confusion about which version controls.

If You Are Pregnant

Louisiana law includes a pregnancy restriction. Under La. R.S. 40:1151.9(E), your advance directive must be interpreted to preserve the life of an unborn child if you are pregnant and an obstetrician determines the probable post-fertilization age is twenty or more weeks, provided your life can be maintained long enough to allow a live birth. In that situation, a directive to withdraw life-sustaining treatment may be overridden even if you clearly expressed a contrary preference. If this concerns you, talk it through with your physician and consider adding a written statement to your directive addressing your wishes during pregnancy.

Advance Directive vs. LaPOST

An advance directive is not a Louisiana Physician Order for Scope of Treatment (LaPOST). The advance directive records your general wishes and takes effect only when you can’t communicate. A LaPOST is a physician’s medical order that translates your goals into specific instructions emergency responders and hospitals must follow immediately.⁸

LaPOST is designed for people with serious, life-limiting illness and a life expectancy of less than six months. The screening conversation with the physician typically covers advanced chronic conditions, progressive weight loss, two or more unplanned hospitalizations in the past year, or advanced frailty.⁹ If you’re healthy and planning ahead, the advance directive is the right document. If you or a family member is facing a terminal diagnosis, ask the treating physician about adding a LaPOST.

1
Louisiana Secretary of State. Louisiana Advance Directive Form
2
FindLaw. Louisiana Revised Statutes Title 40 1151.1
3
Louisiana Governor’s Office of Elderly Affairs. Planning for Incapacity – A Self-Help Guide
4
Louisiana State Legislature. Louisiana Code 40:1159.4 – Persons Who May Consent to Surgical or Medical Treatment
5
Louisiana State Legislature. Louisiana Code 40:1151.2 – Making of Declaration
6
Louisiana State University Law Center. Louisiana Declarations Concerning Life-Sustaining Procedures
7
Justia Law. Louisiana Revised Statutes 40:1151.3 – Revocation of Declaration
8
Louisiana Department of Health. State Implements Tool for End-of-Life Care Planning
9
Louisiana Physician Orders for Scope of Treatment. FAQs – Long-Term Care Professionals