Indiana Advance Directives: Signing, Witnesses, and Revocation

Indiana advance directives are governed by a single statute, Indiana Code 16-36-7, which took effect July 1, 2022 and lets you put your health care instructions into one document that activates only if you lose the ability to make or communicate medical decisions. In that document you can name someone to speak for you, spell out which treatments you do or don’t want, and rule out specific people from ever serving as your decision-maker. Get the signing formalities right and it carries legal force with every provider in the state.

What One Document Can Do

Indiana’s advance directive is flexible by design. A single form can handle any combination of the following:

Name one or more competent adults as your health care representative, with authority to make medical decisions, receive your health information, or both.
Consent to or refuse specific treatments in advance, so providers know your wishes directly instead of relying on someone else’s interpretation.
Address life-prolonging procedures, comfort care, palliative care, help with daily activities, and whether life-sustaining treatment should continue, start, or stop.
Disqualify specific people from serving as your representative, acting as your proxy, or receiving delegated authority from your representative.

You don’t have to use all four functions. A directive that only names a representative is valid. So is one that only states treatment preferences without naming anyone.¹

Signing Requirements

An advance directive that doesn’t meet Indiana’s signing rules has no legal effect, no matter how clearly it expresses your wishes. Two steps.

Your Signature

You sign the directive yourself. If you physically cannot, another adult can sign your name at your specific direction while you are present. That person cannot also serve as a witness, as the notarial officer, or as a health care representative named in the document.¹

Witnesses or a Notary

You then satisfy one of two options:

Two adult witnesses who sign in your presence. At least one of them must not be your spouse or relative. The second witness can be a relative.
A notarial officer who signs and completes a notarial certificate. Remote online notarization that complies with Indiana’s electronic notarization law (IC 33-42-17) qualifies.

Only one of the two methods is required. If your document happens to include both witness signatures and a notarial certificate, the extra formality doesn’t hurt.¹

A common misread of the current law: people assume both witnesses must be unrelated to you. Only one has to be. If you’re completing the form at home with family around, that matters.

Choosing a Health Care Representative

Your health care representative speaks for you when you can’t speak for yourself. Indiana requires that the person be at least 18 years old and a competent adult.² The statute doesn’t require any professional credential. Most people name a spouse, adult child, sibling, or close friend.

Practical fit is what matters. Pick someone who understands your values, will hold to your wishes under family pressure, and can actually be reached in an emergency. You can name more than one representative in a priority order, so a backup steps in if your first choice is unavailable. You can also use the directive to explicitly disqualify specific people from ever serving, which heads off predictable family disputes before they start.¹

Naming a representative gives that person decision-making authority, but authority to decide and authority to see your records are separate matters under federal privacy law. Indiana’s statute lets you designate someone in the directive itself to receive your health information, and using that provision (or signing a separate HIPAA authorization) avoids the situation where your representative can legally choose your treatment but can’t get the medical information needed to choose well.¹

When the Directive Takes Effect

Your directive does not override your own voice. As long as you have decision-making capacity, you make your own medical choices regardless of what the document says. The directive activates when a determination is made under IC 16-36-7-35 that you cannot make or communicate health care decisions.

Once it’s in effect, your representative steps into the decision-making role, and Indiana law is direct with providers: they must comply with the health care decisions your representative communicates.³

If a Provider Objects

Not every provider will carry out every decision. A provider who objects must notify the representative and promptly take all necessary steps to transfer your care to another provider the representative designates. The objecting provider isn’t required to find the alternative provider, but cannot simply ignore the directive. If your condition makes transfer medically dangerous or impractical, the provider can invoke the facility’s dispute resolution process with the goal of reaching a decision in your best interest.³

Changing or Revoking Your Directive

Nothing about an advance directive is permanent. Indiana gives you three ways to revoke:

Sign a new advance directive. It must meet the same signing and witnessing rules as the original. This is the cleanest option because it revokes the old directive and replaces it in one step.
Sign a written revocation. A separate document stating that you’re revoking the prior directive, signed and witnessed under IC 16-36-7-28. If your original directive set conditions for revocation, the written revocation must confirm those conditions are met.
Revoke orally. You can state your intention to revoke the directive, or specific parts of it, in the direct physical presence of a health care provider. This works for revoking the entire directive, removing a named representative, or withdrawing specific treatment decisions.

If you have not been determined incapacitated, you always keep the right to orally revoke any specific health care decision or treatment preference in your directive, even if the directive itself says otherwise.⁴

One trap. The current statute does not list physical destruction of the document as a valid revocation method. Tearing up the paper copy without using one of the three methods above may not legally revoke the directive, particularly if copies exist in your medical records or with your representative.

If you want to change your directive without starting over, you can amend or restate it. The amendment must be in writing, signed, and witnessed or notarized the same way as the original, and it can include anything the original could have included.⁴ Whenever you revoke or amend, notify your representative, your doctors, and anyone else holding a copy. An outdated version in your medical records can override your current wishes if nobody knows about the change.

Storing and Sharing the Document

Indiana does not maintain a state registry for advance directives, so making sure yours is available when it matters is on you. Keep the original somewhere secure but accessible, such as a fireproof safe that someone else can open. Give copies to your health care representative, your primary care physician, and any hospital or specialist you see regularly. Indiana law requires that an advance directive be made part of your medical records, so providers should file the copy you give them.³

For emergencies where your regular providers aren’t in the room, practical backups help. A wallet card noting the directive exists and listing your representative’s contact information travels with you. Smartphone medical ID features (the Health app on iPhone, comparable third-party apps on Android) let first responders see key information from the lock screen. Neither replaces the legal document, but both help someone find it.

POST Forms: A Companion, Not a Substitute

Indiana’s Physician Orders for Scope of Treatment (POST) form, governed by IC 16-36-6, is not an advance directive. It’s an actual medical order, signed by both you and your doctor, that emergency responders and medical staff can act on immediately without interpretation. Your advance directive expresses your wishes and names a representative; the POST form converts specific choices into orders that travel with you across treatment settings.

The POST form covers four areas: CPR, the level of medical intervention (comfort measures only, limited intervention, or full intervention), antibiotic use, and artificially administered nutrition. It also has an optional section for appointing a health care representative. If you use that section, the POST appointment supersedes any earlier representative appointment, which can create conflicts if you’re not careful. Make sure your POST form and your advance directive name the same person, or that you intend the change.

Older Documents From Before the 2022 Reform

If you signed a living will under IC 16-36-4 or a health care representative appointment under IC 16-36-1 before July 1, 2022, those documents are not automatically void. The older chapters remain in the Indiana Code, and documents properly executed under them generally still carry legal weight. Health care powers of attorney created under IC 30-5 before January 1, 2023 also remain valid.

What changed is the door going forward. Any health care power of attorney executed under IC 30-5 after December 31, 2022 is void as to the health care provisions, even though the rest of the power of attorney survives.⁵ If you’re relying on a pre-2023 health care power of attorney, replacing it with a unified advance directive under IC 16-36-7 is worth the effort. The current law is what providers and hospitals are trained on, and a modern document avoids confusion when overlapping forms exist. IC 16-36-7-44 addresses conflicts between multiple documents, but preventing the conflict is simpler than resolving one during a medical crisis.

Out-of-State Directives

If you signed an advance directive in another state before moving to Indiana, or you travel often, Indiana recognizes it if two things are true: you were not incapacitated when you signed, and the document was either signed in compliance with Indiana’s requirements or in compliance with the law of the state where you resided or were physically located when you signed.¹

Going the other direction is less predictable. If you have an Indiana directive and need care in another state, that state’s law controls whether it honors your document. Reciprocity provisions vary. If you split time between states, executing a directive that complies with both states’ laws is the safest approach.

1
Indiana General Assembly. Indiana Code 16-36-7-28 – Advance Directive; Signature; Witnesses; Acknowledgement; Counterparts; Telephonic Interaction; Validity
2
Indiana Department of Disability and Rehabilitative Services. Advanced Directive FAQ
3
Indiana General Assembly. Indiana Code 16-36-7-37 – Advance Directive Made Part of Medical Records; Capacity; Compliance With Decisions by Health Care Representative
4
Indiana General Assembly. Indiana Code 16-36-7-32 – Revocation; Amendment or Restatement
5
Indiana General Assembly. Indiana Code 30-5-5-16 – Health Care Powers; Religious Tenets; Funeral Planning Declaration; Application for Public Benefits