Connecticut Healthcare Power of Attorney Requirements

Q: What is an Appointment of Health Care Representative in Connecticut?

An Appointment of Health Care Representative in Connecticut is a legal document, created under Connecticut General Statutes Sections 19a-576 and 19a-577, that lets you name a trusted adult, your health care representative, to make health care decisions for you if you ever become unable to make them yourself. It covers only health care decisions, such as accepting or refusing treatment, and it takes effect only after your attending physician or advanced practice registered nurse determines you are incapacitated.

Q: What is the difference between an Appointment of Health Care Representative and a Durable Power of Attorney in Connecticut?

An Appointment of Health Care Representative covers only health care decisions. Connecticut's Uniform Power of Attorney Act, Title 1, Chapter 15c, covers property and financial matters instead, and by its own terms does not apply to health care decisions at all. The two documents also start differently. A financial power of attorney is durable by default, meaning it survives your incapacity unless you state otherwise, and it takes effect as soon as it is signed. The Appointment of Health Care Representative has no such immediate-effect option. It is signed and effective right away as a document, but your representative's actual authority always waits until the document reaches your physician and that physician determines you are incapacitated.

Q: Can I revoke my Connecticut Appointment of Health Care Representative by just telling someone?

No. Unlike many states, Connecticut requires a written revocation, signed by you and by two witnesses, to cancel an Appointment of Health Care Representative (Conn. Gen. Stat. Section 19a-575a(b)). A purely oral or verbal statement is not legally effective for this document, even though Connecticut does allow oral revocation of a plain living will under a different section.

Q: Does a notary need to witness my Connecticut Appointment of Health Care Representative?

No, and a notary cannot replace your two required witnesses. Connecticut law requires you to sign in the presence of two adult witnesses who also sign the document (Section 19a-576(a)). A notary can later take a sworn affidavit from your witnesses to make the document easier to prove in court (Section 19a-578(a)), but this step is optional and does not substitute for the witness signatures at execution.

Q: Are there special witness rules if I live in a Connecticut care facility?

Yes, but only for two specific types of facilities. If you reside in a facility operated or licensed by the Department of Mental Health and Addiction Services, at least one witness must be unaffiliated with the facility and at least one must be a physician, advanced practice registered nurse, or licensed clinical psychologist with training in mental illness. The same unaffiliated-witness rule, plus a clinician trained in developmental disabilities, applies in Department of Developmental Services facilities (Conn. Gen. Stat. Section 19a-576(b) and (c)).

Q: Can my doctor act as my health care representative in Connecticut?

Not if that person is also your attending physician or advanced practice registered nurse. Connecticut law bars a physician or APRN from acting as both your health care representative and your attending clinician at the same time (Conn. Gen. Stat. Section 19a-576(e)). Separately, if you are a patient or resident of certain facilities, an operator, administrator, or employee of that facility generally cannot serve as your representative unless they are your relative.

Q: Does Connecticut have a state registry for the Appointment of Health Care Representative?

No. Connecticut does not operate a central registry for this document. You keep the signed original yourself and give copies to your physician, your health care representative, and any alternate representative so they have it when it is needed.

Q: When does my Connecticut health care representative's authority actually begin?

Only after two things both happen: the signed document is furnished to your attending physician or advanced practice registered nurse, and that physician or APRN determines that you are incapacitated (Conn. Gen. Stat. Section 19a-579). Until both conditions are met, you continue making your own health care decisions.

Introduction

Connecticut's own statute never uses the phrase "power of attorney" for this document: it is officially the Appointment of Health Care Representative, and the person you name to make health care decisions for you if you're ever unable to make them yourself is your health care representative, not an agent or attorney-in-fact. It is created and governed by Chapter 368w of the Connecticut General Statutes, primarily Sections 19a-576 and 19a-577, or the combined form at Section 19a-575a, which adds health care instructions, a future conservator designation, and an anatomical gift into the same document. Like the equivalent document in most states, this covers only health care decisions, not your money, property, or bills. It also works differently than many people assume, in two ways. First, signing it does not hand your representative immediate authority. Your representative can only start deciding for you once the document reaches your attending physician or advanced practice registered nurse and that clinician determines you are incapacitated. Second, if you ever want to cancel it, Connecticut requires a written revocation signed by you and two witnesses. You cannot revoke it with a spoken statement alone, which is different from the rule in some other states. Connecticut requires two adult witnesses to sign your document. Unlike some states, Connecticut does not let a notary stand in for the witnesses, though a notary can later help create a sworn statement proving the document was properly signed. The Connecticut Office of the Attorney General publishes the official forms, and there is no state registry to file the document with. You simply keep the signed original and give copies to your physician and your representative.

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Key Things to Know

1
Connecticut does not call this a "power of attorney" at all: the statute names it an Appointment of Health Care Representative, and it lets you (the declarant) name a trusted adult (your health care representative) to make health care decisions for you if you become unable to make them yourself.
2
Your representative's authority does not start the moment you sign. It begins only after your document reaches your attending physician or advanced practice registered nurse and that clinician determines you are incapacitated (Conn. Gen. Stat. Section 19a-579).
3
Once active, your representative can accept or refuse any treatment, service, or procedure and can decide about life support systems, except for psychosurgery or shock therapy, which the law treats separately (Section 19a-577).
4
Your representative cannot be a physician or advanced practice registered nurse who is also serving as your attending physician or APRN (Section 19a-576(e)).
5
You must sign in front of two adult witnesses, who must also sign. Your representative cannot be one of your witnesses, and Connecticut does not allow a notary to replace the witnesses (Section 19a-576(a)).
6
If you live in a facility run or licensed by the Department of Mental Health and Addiction Services or the Department of Developmental Services, at least one witness must be unaffiliated with the facility and at least one must be a qualified clinician (Section 19a-576(b) and (c)).
7
You can only revoke this document in writing, signed by you and two witnesses. Telling someone verbally that you revoke it is not enough under Connecticut law (Section 19a-575a(b)).
8
If you name your spouse as your representative and later divorce or legally separate, their authority ends automatically unless your document says otherwise (Section 19a-579b).
9
Connecticut has no central state registry for this document. Keep the signed original and give copies to your physician, your representative, and any alternate representative.

Key decisions before you file

Before you file a Healthcare Power of Attorney in Connecticut, 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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CONNECTICUT APPOINTMENT OF HEALTH CARE REPRESENTATIVE - STATE EXECUTION TEMPLATE

NOTICE: Connecticut law does not call this a "power of attorney"; it is an Appointment of Health Care Representative, created under Connecticut General Statutes Sections 19a-575a, 19a-576, and 19a-577. Signing it lets you (the "declarant") choose a trusted adult (your "health care representative") to make health care decisions on your behalf once you are unable to make them yourself. This document has no authority over money, property, or financial matters.

Designation of Health Care Representative I, [Declarant Name], of [Town], Connecticut, appoint [Representative Name], of [Representative Address and Phone], to be my health care representative. If this person is unwilling or unable to serve, I appoint [Alternate Representative Name] to be my alternative health care representative.
Grant of Authority Once my representative's authority begins, my representative is authorized to accept or refuse any treatment, service, or procedure used to diagnose or treat my physical or mental condition, and to decide whether to provide, withhold, or withdraw life support systems. This authority does not extend to psychosurgery or shock therapy except as otherwise provided by law. My representative must act according to my wishes, or, if my wishes are unknown, in my best interest.
When My Representative's Authority Begins This document takes legal effect once I sign it, but my representative's decision-making authority does not begin until this document is furnished to my attending physician or advanced practice registered nurse, and that physician or advanced practice registered nurse determines that I am incapacitated.
Representative Restrictions My representative may not be a physician or advanced practice registered nurse who is also serving as my attending physician or APRN. If, at the time of this appointment, I am a patient or resident of, or an applicant to, a hospital, residential care home, rest home with nursing supervision, or chronic and convalescent nursing home, an operator, administrator, or employee of that facility may not serve as my representative, unless related to me by blood, marriage, or adoption.
Revocation I may revoke this appointment only in writing, signed by me and by two witnesses. A spoken statement of revocation is not effective for this document.

EXECUTION (Connecticut General Statutes Section 19a-576) I must sign and date this document in the presence of two adult witnesses, who must also sign it. My representative may not act as one of my witnesses or sign this document. Connecticut does not permit a notary to substitute for the two witnesses. If I reside in a facility operated or licensed by the Department of Mental Health and Addiction Services or the Department of Developmental Services, at least one witness must be unaffiliated with the facility, and at least one witness must be a physician, advanced practice registered nurse, or licensed clinical psychologist with the relevant specialized training.

Note: This page covers Connecticut's representative-designation, activation, and execution requirements only. For decisions about money and property, see Connecticut's separate Durable (Financial) Power of Attorney.

Once your Healthcare Power of Attorney is ready, you can check whether it needs to be notarized in Connecticut in about a minute, and notarize it online through DocDraft if it does.

Connecticut Requirements for Healthcare Power of Attorney

Designation of Health Care Representative (Connecticut General Statutes Section 19a-577)
The declarant designates a health care representative using the statutory form (Conn. Gen. Stat. Section 19a-577, or the combined form at Section 19a-575a), which also lets the declarant name an alternative representative who serves if the first choice is unwilling or unable to act.
Alternate Representative Designation (Connecticut General Statutes Section 19a-577)
The statutory form includes a block for naming an alternative health care representative who assumes authority if the first-named representative is unwilling or unable to serve (Conn. Gen. Stat. Section 19a-577; also present in the combined form at Section 19a-575a).
Scope of Representative's Authority (Connecticut General Statutes Section 19a-577)
The statutory form authorizes the representative to accept or refuse any treatment, service, or procedure used to diagnose or treat the declarant's physical or mental condition, and to decide whether to provide, withhold, or withdraw life support systems, once the representative's authority is triggered. This authority does not cover psychosurgery or shock therapy except as otherwise provided by law (Conn. Gen. Stat. Section 19a-577; shock therapy defined at Section 17a-540).
HIPAA Authorization (45 CFR Section 164.508)
Federal HIPAA regulations govern how the representative can be authorized to access the declarant's protected health information once the appointment is in effect.
Life-Sustaining Treatment Instructions in the Combined Form (Connecticut General Statutes Section 19a-575a)
A declarant who chooses the combined form (Conn. Gen. Stat. Section 19a-575a), rather than the standalone Appointment of Health Care Representative (Section 19a-577), can include specific instructions about life-sustaining treatment, including artificial nutrition and hydration, in the same document as the representative appointment.
Anatomical Gift Authorization in the Combined Form (Connecticut General Statutes Section 19a-289j(a))
The combined statutory form (Conn. Gen. Stat. Section 19a-575a) lets a declarant make an anatomical gift effective on death, for any of the purposes stated in Section 19a-289j(a) or for limited purposes the declarant specifies. This is only available through the combined form, not the standalone Appointment of Health Care Representative (Section 19a-577).
Limits on Psychosurgery and Shock Therapy Decisions (Connecticut General Statutes Section 19a-577; Section 17a-540)
Connecticut's statutory form language expressly carves psychosurgery and shock therapy out of the representative's general treatment authority, except as otherwise provided by law, with shock therapy defined by cross-reference to Section 17a-540.
Pregnancy Instructions in the Combined Form (Connecticut General Statutes Section 19a-575a)
The combined statutory form (Conn. Gen. Stat. Section 19a-575a) includes a checkbox section letting a declarant state whether life support systems should be continued if the declarant is pregnant and continuing them would allow the fetus to reach a live birth, or whether the document should apply without modification.
Witness Requirements (Connecticut General Statutes Section 19a-576)
The declarant signs and dates the document in the presence of two adult witnesses, who must also sign it; the appointed representative cannot serve as a witness (Conn. Gen. Stat. Section 19a-576(a)). Connecticut's general witness rule does not disqualify relatives, estate beneficiaries, or treating physicians the way some other states' laws do. Residents of facilities operated or licensed by the Department of Mental Health and Addiction Services or the Department of Developmental Services face additional, narrower witness-composition rules (Section 19a-576(b), (c)).
Optional Self-Proving Affidavit (Connecticut General Statutes Section 19a-578(a))
After execution, the witnesses may, at the declarant's request, sign a sworn affidavit before a notary public or other officer authorized to administer oaths, making the document easier to prove in court later. This step is optional and does not substitute for the two required witness signatures at the time of signing; the document is fully valid without it (Conn. Gen. Stat. Section 19a-578(a)).
Revocation Procedures (Connecticut General Statutes Section 19a-575a(b) to (e))
The declarant may revoke the appointment only in writing, and that writing must be signed by the declarant and two witnesses (Conn. Gen. Stat. Section 19a-575a(b)). A provider told of a revocation must record it in the declarant's medical record (Section 19a-575a(c)); a person unaware of a revocation is protected from liability for carrying out the advance directive in good faith (Section 19a-575a(d)); and revoking the representative appointment does not, by itself, revoke a combined document's living-will instructions (Section 19a-575a(e)).
Compliance with Patient Self-Determination Act (42 U.S.C. Section 1395cc(a))
Facilities that participate in Medicare and Medicaid must inform patients of their rights under state law to make advance directives, including an Appointment of Health Care Representative.
Out-of-State and Foreign Recognition (Connecticut General Statutes Section 19a-580g)
Health care instructions or an appointment of a health care representative validly executed under the law of another state or a foreign country, and not contrary to Connecticut public policy, are recognized as validly executed in Connecticut. A health care provider may rely on such a document based on a court order, a notarized statement that the document is valid where made and not contrary to Connecticut public policy, or the provider's own good-faith legal analysis (Conn. Gen. Stat. Section 19a-580g).

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Frequently Asked Questions

What is an Appointment of Health Care Representative in Connecticut?

What is the difference between an Appointment of Health Care Representative and a Durable Power of Attorney in Connecticut?

Can I revoke my Connecticut Appointment of Health Care Representative by just telling someone?

Does a notary need to witness my Connecticut Appointment of Health Care Representative?

Are there special witness rules if I live in a Connecticut care facility?

Can my doctor act as my health care representative in Connecticut?

Does Connecticut have a state registry for the Appointment of Health Care Representative?

When does my Connecticut health care representative's authority actually begin?

Introduction

Key Things to Know

Key decisions before you file

Customize your Healthcare Power of Attorney Template with DocDraft

Connecticut Requirements for Healthcare Power of Attorney

Designation of Health Care Representative (Connecticut General Statutes Section 19a-577)

Alternate Representative Designation (Connecticut General Statutes Section 19a-577)

Scope of Representative's Authority (Connecticut General Statutes Section 19a-577)

HIPAA Authorization (45 CFR Section 164.508)

Life-Sustaining Treatment Instructions in the Combined Form (Connecticut General Statutes Section 19a-575a)

Anatomical Gift Authorization in the Combined Form (Connecticut General Statutes Section 19a-289j(a))

Limits on Psychosurgery and Shock Therapy Decisions (Connecticut General Statutes Section 19a-577; Section 17a-540)

Pregnancy Instructions in the Combined Form (Connecticut General Statutes Section 19a-575a)

Witness Requirements (Connecticut General Statutes Section 19a-576)

Optional Self-Proving Affidavit (Connecticut General Statutes Section 19a-578(a))

Revocation Procedures (Connecticut General Statutes Section 19a-575a(b) to (e))

Compliance with Patient Self-Determination Act (42 U.S.C. Section 1395cc(a))

Out-of-State and Foreign Recognition (Connecticut General Statutes Section 19a-580g)

Does your Healthcare Power of Attorney need to be notarized in Connecticut?

Frequently Asked Questions