How to Fill Out and Sign Your Illinois Advance Directive Forms

To complete an Illinois advance directive form, download the version that fits your situation from the Illinois Department of Public Health, fill in your agent and treatment preferences, and sign in front of the witnesses that specific form requires. No notary is needed, and no attorney is required.¹

Pick the Right Form First

Illinois recognizes four advance directive documents, and the one you want depends on what you’re trying to control.

The Statutory Short Form Power of Attorney for Health Care is the broadest. You name an agent who can speak with your doctors, consent to or refuse treatments, access medical records, and handle organ donation and disposition of remains. It applies whenever your physician determines you cannot make decisions, or whenever you prefer not to.²
A living will is narrower. It directs your physician to withhold or withdraw death-delaying procedures when you have a terminal condition and death is imminent. Comfort care continues.³
The Mental Health Treatment Preference Declaration covers psychiatric care: psychotropic medications, electroconvulsive therapy, and voluntary admission to a mental health facility for up to 17 days. It expires three years from the date you sign it.⁴
A POLST (Practitioner Orders for Life-Sustaining Treatment) is a medical order signed by both you and your attending practitioner. It’s generally intended for people with a serious illness or limited prognosis, and emergency responders act on it immediately.⁵

Most people start with the health care power of attorney. Many pair it with a living will so there’s a clear instruction for end-of-life situations the power of attorney leaves to the agent’s judgment.

Filling Out the Health Care Power of Attorney

Download the PDF from the Illinois Department of Public Health’s advance directives page.⁶ The form walks through several sections.

Name Your Agent and a Successor

Enter your agent’s full name, address, and phone number. Pick someone who knows your values, stays composed under pressure, and will advocate for your wishes even when they personally disagree. Your agent must be at least 18.

The form has space for one or more successor agents who step in if your primary agent is unavailable or unwilling. Successors are optional, but naming at least one is a sensible backup. Each successor needs a name, address, and phone number.⁶

Avoid naming your attending physician or the operator of a facility where you receive care. The dual role creates an obvious conflict of interest.

Choose a Treatment Preference Statement

The form presents two statements. You pick one.

Quality of life. If you are unconscious and your physician believes, under reasonable medical standards, that you will not wake up or recover the ability to think and communicate, you do not want treatments that prolong life or delay death. Comfort care and pain relief continue.
Prolonging life. You want your life extended to the greatest extent possible regardless of your condition, level of suffering, or likelihood of recovery.

Select only one. This statement becomes the lens your agent uses for every treatment call, so take time to decide which actually reflects your values. If neither feels right, leave both unchecked and write specific instructions in the additional guidance section. Clear written preferences make your agent’s job easier and reduce the chance of family disagreements later.⁶

Organ Donation and Disposition of Remains

A separate section records your wishes about organ and tissue donation and about burial, cremation, or another arrangement. Documenting these preferences gives your agent clear authority and heads off disputes among family members.

Medical Records

Signing the statutory form automatically grants your agent access to your medical records and the authority to decide who else can see them. You don’t need a separate HIPAA authorization — the power is built into the form.⁶

Filling Out a Living Will

The living will is short and has a single purpose: instructing your physician to stop death-delaying procedures if you have a terminal, irreversible condition and death is imminent. Comfort care (medication, sustenance, and other measures your physician considers necessary to relieve pain) continues.³

You must be of sound mind and at least 18, or a legally emancipated minor. Fill in your name, sign, date, and have the document witnessed.

Because the living will only applies when a physician has determined your condition is both terminal and irreversible, it doesn’t cover a temporary coma or a chronic illness with uncertain prognosis. That’s why many people pair it with a health care power of attorney.

Filling Out the Mental Health Treatment Preference Declaration

If you want to give instructions specifically about psychiatric care, use this declaration. It covers psychotropic medications, electroconvulsive therapy, and admission to a mental health facility for up to 17 days.⁴ You can consent to, refuse, or set conditions on each category individually.

The form is available from the Illinois Department of Human Services.⁷ It expires three years after you sign it. If the declaration has been invoked and is actively in effect when the three years run out, it stays effective until you regain capacity. Otherwise, sign a new one to stay covered.

Signing and Witnessing Each Form

Each directive has its own execution rules. Getting the witnesses wrong is probably the most common reason a hospital refuses to honor a document.

Health Care Power of Attorney

You need one adult witness. The following people cannot serve:

Your attending physician, advanced practice registered nurse, physician assistant, dentist, podiatric physician, optometrist, or psychologist, or any of their relatives
An owner or operator of a health care facility where you are a patient or resident, including directors and executive officers of a corporate operator (but not other employees such as chaplains, social workers, or nurses)
A parent, sibling, or descendant, or the spouse of a parent, sibling, or descendant, of either you or your agent, whether the relationship is by blood, marriage, or adoption
Your agent or any successor agent named in the document

Notarization is not required. Illinois also accepts electronic signatures when the system uses unique user identifiers and meets the Uniform Electronic Transactions Act’s standards.⁸

Living Will

Two adult witnesses. Neither can be your attending physician or an employee of your attending physician, and neither should be the person you’ve designated to make health care decisions for you. Notarization is not required, though some people add it for extra authentication.¹

Mental Health Treatment Preference Declaration

Two witnesses, both of whom must personally know you and be present when you sign. Disqualified witnesses include:

The person you appoint as attorney-in-fact in the document
Your attending physician or mental health provider, or a relative of either
An owner or operator of a facility where you are a patient or resident, or a relative of an owner or operator
Anyone related to you by blood, marriage, or adoption

That last restriction trips people up. Unlike the health care power of attorney, you cannot use a family member as a witness for the mental health declaration.⁷

POLST

A POLST is not witnessed. It requires your signature (or your authorized legal representative’s signature) and the signature of your attending practitioner. Without both, it will not be entered into your medical record.¹

After You Sign: Distribute, Store, Update

Illinois does not require you to file an advance directive with a court, and the state does not maintain an electronic registry. Distribution is on you.¹ Give copies to:

Your agent and any successor agents
Your primary care physician, so it goes into your medical file
Any hospital or facility where you regularly receive care
Close family members likely to be present during an emergency

Keep the signed original somewhere at home that someone can reach quickly, not in a safe deposit box your agent cannot open after hours. Illinois law lets you or your agent present an electronic copy of an executed health care power of attorney when the original isn’t available, so scan it and store the file on your phone or in a cloud folder. A wallet card with your agent’s name and phone number helps emergency responders find them.

You can revoke a health care power of attorney at any time, regardless of your mental or physical condition, by:

Destroying the document in a way that shows you intended to revoke it (tearing, burning, defacing)
Signing and dating a written revocation (electronic format counts)
Stating your intent to revoke in front of a witness who is at least 18, who then signs and dates a written confirmation
For an electronic directive, deleting it in a manner that indicates intent to revoke

Illinois also lets you elect a 30-day delay on revocation. If you make that election, the revocation does not take effect until 30 days after you communicate your intent.⁹

A living will or mental health declaration can be canceled at any time by telling someone or by revoking in writing.¹ Whichever route you take, notify your agent, your successors, and every provider holding a copy. An outdated directive still sitting in a chart causes real confusion.

What Happens If You Skip the Form

If you become incapacitated without any advance directive, Illinois does not leave you without a decision-maker, but you lose control over who it is. Under the Health Care Surrogate Act, your provider must make a reasonable effort to identify a surrogate from a statutory priority list that starts with a court-appointed guardian and spouse and moves through adult children, parents, siblings, grandchildren, a close friend, and finally the guardian of your estate.¹⁰

The surrogate system works, but it is slower and messier than naming your own agent. Treatment decisions wait while providers search for family, resolve disagreements at the same priority level, and sometimes end up in probate court. Filling out the form puts someone you trust in charge from the start.

1
Illinois Department of Public Health. Advance Directives
2
Illinois General Assembly. Illinois Code 755 ILCS 45/4-10 – Statutory Short Form Power of Attorney for Health Care
3
Illinois General Assembly. Illinois Code 755 ILCS 35/3 – Execution of a Document
4
Illinois General Assembly. Illinois Code 755 ILCS 43 – Mental Health Treatment Preference Declaration Act
5
Illinois General Assembly. Illinois Compiled Statutes 755 ILCS 40/65 – Department of Public Health Uniform POLST Form
6
Illinois Department of Public Health. Illinois Statutory Short Form Power of Attorney for Health Care
7
Illinois Department of Human Services. Declaration for Mental Health Treatment
8
Justia Law. Illinois Code 755 ILCS 45 Article IV – Powers of Attorney for Health Care
9
Illinois General Assembly. Illinois Code 755 ILCS 45/4-6 – Revocation
10
FindLaw. Illinois Statutes Chapter 755 Estates 40/25 – Surrogate Decision Making