California Healthcare Power of Attorney Requirements
California does not have a standalone document called a Medical Power of Attorney.
Introduction
California does not have a standalone document called a Medical Power of Attorney. What this page covers, the power of attorney for health care, is legally just Part 1 of a single combined instrument called the Advance Health Care Directive, created by the Health Care Decisions Law (Probate Code Sections 4600 through 4806). It still does the job you would expect: it lets you name someone you trust, called an agent, to make health care decisions for you if you are ever unable to make them yourself. The same combined form's Part 2 lets you separately write down your own treatment wishes, but this page covers only the agent-designation part. Unlike some states, California does not force your agent's authority to spring into effect only on incapacity. By default, your agent can only start deciding for you once your primary physician determines you are unable to decide for yourself, but you can choose, right on the form, to make your agent's authority begin immediately instead, even while you are still capable of deciding for yourself. California gives you two ways to make the document legally valid: sign it before a notary public, or sign it in front of two qualified witnesses. If you live in a skilled nursing facility when you sign, an additional patient advocate or ombudsman witness is required no matter what. The California Secretary of State also runs a voluntary registry you can file the directive with, though registering is never required for it to be valid.
Key Things to Know
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California does not issue a separate Medical Power of Attorney form. What you are signing is Part 1 of the combined Advance Health Care Directive, and it works by letting you name a trusted adult, your agent, to make health care decisions for you if you ever cannot make them yourself.
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By default, your agent's authority begins only after your primary physician determines you cannot make your own health care decisions (Probate Code Section 4682), but you can mark the document to make your agent's authority begin immediately instead.
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Unless you limit it, your agent can make any health care decision you could make yourself, including decisions about life-sustaining treatment, and can also make anatomical gift, autopsy, and remains-disposition decisions after your death.
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Your supervising health care provider, or an employee of the facility where you are receiving care, generally cannot be your agent, unless that person is your relative, your registered domestic partner, or a coworker at the same facility (Section 4659).
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You can sign before a notary public or in front of two qualified witnesses. If you are a resident of a skilled nursing facility, a patient advocate or ombudsman must also witness the document, even if it is notarized.
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You can revoke your agent's designation at any time you have capacity, but only by a signed writing or by personally telling your supervising health care provider. Simply telling a family member is not enough.
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No agent can ever consent, on your behalf, to your commitment to a mental health facility, convulsive treatment, psychosurgery, sterilization, or abortion, no matter what your document says (Section 4652).
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California runs a voluntary Advance Health Care Directive registry through the Secretary of State, but filing with it is optional and has no effect on whether your document is valid.
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This is a different document from California's general Power of Attorney (Probate Code Division 4.5), which covers property and money and, by its own printed notice, does not authorize anyone to make health care decisions for you.
Key decisions before you file
Before you file a Healthcare Power of Attorney in California, a few decisions shape the document: which option to choose and what each one means. The Healthcare Power of Attorney guide walks through them.
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California Requirements for Healthcare Power of Attorney
The principal designates a primary health care agent, with full name and contact information, using Part 1 of the statutory Advance Health Care Directive form (Probate Code Section 4701); the form also lets the principal name one or more alternate agents who serve if the primary agent is unwilling, unable, or not reasonably available.
The statutory form lets the principal designate at least one alternate agent to serve if the primary agent is unwilling, unable, or unavailable to act, with each alternate identified by contact information.
Unless the principal states otherwise, the agent's authority becomes effective only on a determination that the principal lacks capacity, and ceases if the principal later regains capacity (Probate Code Section 4682). This is a default rule, not a mandatory one: the statutory form lets the principal instead mark an election making the agent's authority effective immediately upon signing, while still competent.
Subject to any limitations the principal states, the agent may make any health care decision the principal could make personally, including consenting to, withholding, or withdrawing treatment, and directing artificial nutrition, hydration, and cardiopulmonary resuscitation (Section 4683(a)). The agent may also make decisions effective after the principal's death: anatomical gifts under the Uniform Anatomical Gift Act, authorizing an autopsy, and directing disposition of remains (Section 4683(b)).
Federal HIPAA regulations govern how the agent can be authorized to access the principal's protected health information once the directive is in effect.
Part 2 of the statutory form lets the principal choose, in advance, between prolonging life within generally accepted health care standards or not prolonging life if an incurable and irreversible condition, permanent unconsciousness, or an unfavorable risk-benefit balance applies; the agent's authority under Part 1 to make end-of-life decisions on the principal's behalf independently derives from Section 4683(a).
The Uniform Anatomical Gift Act governs the agent's post-death authority to make anatomical-gift decisions under Probate Code Section 4683(b)(1).
No agent, regardless of how the document is written, may consent on the principal's behalf to commitment to or placement in a mental health treatment facility, convulsive treatment, psychosurgery, sterilization, or abortion (Probate Code Section 4652). This is a fixed statutory exclusion, not something the principal can grant by specifying it in the document.
The advance health care directive may include the principal's nomination of a conservator of the person or estate, for a court's consideration if conservatorship proceedings are later commenced, typically nominating the same person as the health care agent.
The principal signs before at least two qualified adult witnesses, or alternatively has the signature acknowledged before a notary public, with no witnesses required in that case (Section 4673). Neither witness may be the agent, the principal's health care provider or that provider's employee, or the operator or employee of a community care facility or residential care facility for the elderly; at least one witness must additionally be unrelated to the principal and not entitled to any part of the principal's estate (Section 4674).
Health care facilities that participate in Medicare and Medicaid must inform patients of their rights under state law to make advance directives, including a power of attorney for health care.
A principal with capacity may revoke the designation of an agent only by a signed writing or by personally informing the supervising health care provider (Section 4695(a)); this is a stricter rule than the one for revoking the separate treatment instructions. A provider informed of a revocation must promptly notify the agent and any other known current providers (Section 4696).
The Uniform Anatomical Gift Act governs organ, tissue, and body donation, consistent with the agent's post-death authority under Probate Code Section 4683(b)(1).
The principal may grant the agent authority over the principal's personal care, including determining where the principal will live, which covers nursing-home or long-term-care admission and placement decisions (Probate Code Section 4671(b)).
Use of the statutory form is optional, not mandatory (Section 4700), but the document should substantially comply with California's combined statutory Advance Health Care Directive form to ensure recognition by health care providers.
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Check my Healthcare Power of AttorneyFrequently Asked Questions
A Power of Attorney for Health Care in California is the part of your Advance Health Care Directive, governed by Probate Code Division 4.7, that lets you name a trusted adult, your agent, to make health care decisions for you. It covers only health care decisions, such as consenting to or refusing treatment, and it is Part 1 of California's combined statutory directive form, alongside a separate part for your own treatment instructions.
A Power of Attorney for Health Care covers only health care decisions. California's general Durable Power of Attorney, under Probate Code Division 4.5, covers property and financial matters instead, and its own statutory form states plainly that it does not authorize anyone to make medical decisions for you. The two also default differently: the financial form is effective immediately and stays effective through incapacity unless you strike that language, while the health care form only takes effect once your physician certifies incapacity, unless you affirmatively choose to make it effective immediately.
No. California does not have two documents. The Power of Attorney for Health Care is Part 1 of one combined statutory instrument called the Advance Health Care Directive (Probate Code Sections 4600 through 4806). Part 2 of that same form lets you separately state your own treatment wishes. You can complete either part alone or both together in the same signed document.
Your supervising health care provider, or an employee of the health care institution, community care facility, or residential care facility where you receive care, generally cannot serve as your agent (Probate Code Section 4659). Either may still serve if that person is related to you by blood, marriage, or adoption, is your registered domestic partner, or is a coworker at that same facility.
Yes. If you are a patient in a skilled nursing facility when you sign, your directive is not effective unless a patient advocate or ombudsman designated by the Department of Aging also signs as a witness, either as one of your two witnesses or in addition to notarization (Probate Code Section 4675). Notarization alone does not satisfy this rule.
You can revoke your agent's designation at any time you have capacity, but only in one of two specific ways: a signed writing, or personally informing your supervising health care provider (Probate Code Section 4695). Telling a family member, or any other informal notice, does not revoke the agent designation itself.
Yes, but it is optional. The California Secretary of State operates a voluntary Advance Health Care Directive Registry (Probate Code Section 4800) that health care providers can query on request. Registering has no bearing on whether your document is legally valid, and failing to register does not affect it.
No. Regardless of how broadly your Power of Attorney for Health Care is written, no agent or surrogate may consent, on your behalf, to your commitment to a mental health treatment facility, convulsive treatment, psychosurgery, sterilization, or abortion (Probate Code Section 4652). These decisions fall outside what any California health care agent can authorize.