The Virginia advance directive form is a free legal document that lets you name a healthcare agent and record which medical treatments you want or refuse if you can no longer speak for yourself. The suggested language appears in Virginia Code § 54.1-2984, and the Virginia State Bar publishes a fillable PDF that matches the statute. You don’t need a lawyer, a notary, or a filing fee. You need your signature and two adult witnesses.1Virginia Code § 54.1-2984
Where to Download the Form
The Virginia State Bar hosts a formatted PDF of the statutory form as a free download. The Virginia Department of Health also links to registry resources that include the form. You are not locked into the state’s version: Virginia law says an advance directive “may, but need not, be in the following form,” so any written document that meets the signing requirements of § 54.1-2983 is valid. The official form is still the safest choice because hospitals recognize it on sight and it covers every option the statute contemplates.
Option I: Naming Your Healthcare Agent
The first section of the form, labeled Option I, is where you appoint someone to make healthcare decisions for you if a physician finds you incapable of making them yourself. Write in your primary agent’s full legal name, address, and phone number, then do the same for an alternate agent who steps in if your first choice is unavailable or unwilling.
Pick people who know your values, can handle pressure, and live close enough to respond quickly. Your agent can be a spouse, adult child, close friend, or anyone else you trust. There is no legal bar against relatives serving. If you cross out both Option I and Option II, you are left with a blank document, so most people complete at least one. Appointing an agent is the more flexible choice because no form can anticipate every medical scenario; your agent fills the gaps in real time.
What Powers Your Agent Gets by Default
Under the form’s standard language, your agent can consent to or refuse any type of care, including medications, surgery, blood transfusions, chemotherapy, radiation, mechanical ventilation, artificially administered nutrition and hydration, and CPR. The agent can authorize your admission to a hospital, nursing home, or assisted living facility, and can approve your discharge or transfer.
The authority runs further than most people expect. Your agent can grant liability releases to providers, authorize release of your medical records, control who may visit you, and approve your participation in clinical research, including studies with no direct therapeutic benefit to you if you check that option. If any of that makes you uncomfortable, use the blank lines to write in restrictions. You could prohibit experimental treatments, for example, or limit the visiting-restriction power.
Three procedures are off-limits to your agent no matter what the form says: nontherapeutic sterilization, abortion, and psychosurgery.
Mental Health Admission and Treatment
The form includes a specific provision allowing your agent to authorize your admission to a mental health facility for up to 10 calendar days, provided you do not protest and a physician at the proposed facility examines you and certifies in writing that you have a mental illness, are incapable of making an informed decision about admission, and need facility-based treatment. If you protest, your agent loses this authority unless your directive expressly grants continuing authority over your later objections. You can also include instructions about specific mental health treatments, such as whether you authorize or refuse psychotropic medications.
Option II: Your End-of-Life Instructions
Option II is the “election of natural death” section, commonly called a living will. Here you state whether you want life-prolonging procedures used, withheld, or withdrawn if your attending physician determines you have a terminal condition. Virginia defines a terminal condition as one caused by injury, disease, or illness from which you cannot recover to a reasonable degree of medical probability, and either death is imminent or you are in a persistent vegetative state.
The form lets you specify your wishes about several categories of intervention:
- Cardiopulmonary resuscitation (CPR): whether staff should try to restart your heart or breathing.
- Mechanical ventilation: whether a machine should breathe for you.
- Artificial nutrition and hydration: whether you want tube feeding or IV fluids to sustain you.
You can also state that you want maximum pain relief even if the medication might hasten death. Blank lines let you write in specific scenarios. You might want ventilator support for a defined trial period to see if you improve, but not indefinitely.
The Optional Pregnancy Section
The form includes an optional pregnancy provision where you can modify your end-of-life instructions if you are pregnant when a terminal condition is diagnosed. It only applies if you fill it in. You might instruct providers to continue life-prolonging procedures until the fetus reaches viability, or you might direct that your general instructions apply regardless of pregnancy. If you leave it blank, your other instructions govern.
Organ and Tissue Donation
A separate section documents your wishes about anatomical gifts after death. You can donate all organs and tissues, limit the gift to specific organs, or restrict donation to particular purposes such as transplant, research, or education. This section works independently from the rest of the directive: donation preferences apply after death, while the treatment instructions apply while you are alive. Virginia law also lets your agent carry out an anatomical gift on your behalf if you grant that authority in the directive.
How to Sign the Form
Once every section that applies to you is filled in, sign the form in the presence of two witnesses. Both witnesses must be at least 18 years old. Virginia is unusually permissive about who qualifies: spouses, blood relatives, and even employees of healthcare facilities or physician’s offices may serve, as long as they act in good faith. Each witness signs a line on the form confirming you signed in their presence.
Virginia does not require notarization. The moment you and both witnesses sign, the directive is legally effective under the Health Care Decisions Act. Skip the witnesses, or use only one, and the directive is unenforceable. There is no workaround.
When the Directive Actually Takes Effect
The directive sits dormant until your attending physician determines you are incapable of making an informed decision. Virginia law presumes every adult is capable, and no one can be deemed incapable based only on a clinical diagnosis. Activation normally requires two certifications: your attending physician must examine you in person and certify in writing that you lack capacity, and a separate capacity reviewer who is not otherwise involved in your treatment must independently examine you and reach the same written conclusion.
The capacity-reviewer step is waived if you are unconscious or experiencing a profound impairment of consciousness from trauma, stroke, or another acute condition. In that situation, your attending physician’s certification alone activates the directive. A capacity determination can be narrow (one specific decision) or broad (all healthcare decisions), and it must be renewed at least every 180 days as long as you continue to need care. If a physician later determines through a personal evaluation that you have regained capacity, the directive goes back to sleep and you resume making your own decisions.
Who Should Get a Copy
Virginia maintains a free online registry, the Advance Health Care Planning Registry operated through ConnectVirginia, where you can store your directive so providers statewide can retrieve it. Registration is free for Virginia residents. You can submit through the registry’s online portal or call 1-800-548-9455 (1-800-LIV-WILL), Monday through Friday, 9:00 a.m. to 5:00 p.m. Eastern. Only the person who executed the directive, or their legal representative, may submit it.
Don’t rely on the registry alone. Give physical copies to:
- Your primary care physician, so it goes into your chart.
- Your healthcare agent and alternate, who need to know what the directive says and where the original lives.
- Any hospital or specialist where you receive regular treatment.
- Close family members, so a copy is on hand when emotions are high.
Keep the original where someone can find it quickly. A bedside drawer or a clearly labeled folder works. A locked safe no one can open at 2 a.m. does not.
Changing or Revoking the Directive
You can revoke the directive at any time, as long as you understand what you are doing. Virginia recognizes three methods:
- A signed, dated written statement expressing your intent to revoke.
- Physically destroying the document yourself, or having someone else destroy it in your presence at your direction.
- An oral statement that you intend to revoke.
You can also revoke part of the directive while leaving the rest in place, as long as what remains does not conflict with itself. A revocation takes effect the moment you communicate it to your attending physician. No one faces liability for failing to honor a revocation they did not know about, so tell your doctor promptly.
Two life events automatically end your agent’s authority: filing for divorce or annulment from your agent, or filing a petition for custody or visitation of a child you share with your agent. In either case the agent’s power ends by operation of law, with no further action required from you.
If your directive is on file with the state registry, you will need to notarize the revocation before submitting it to the Department of Health for removal. Failing to notify the registry does not invalidate the revocation, but an outdated directive sitting in a database hospitals check is an obvious source of confusion. Update the registry, tell your doctors, and collect old copies from everyone who has one.