Vermont Healthcare Power of Attorney Requirements
Vermont skips the label "Medical Power of Attorney" altogether.
Introduction
Vermont skips the label "Medical Power of Attorney" altogether. State law folds agent appointment and treatment instructions into a single instrument it simply calls an Advance Directive, created and governed by Title 18, Chapter 231 of the Vermont Statutes (18 V.S.A. Sections 9701 through 9720). It still does the job those other-state documents do: 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, while also letting you record your own wishes about future medical care in that same document. Unlike a financial power of attorney, this document covers only health care and related decisions, such as anatomical gifts and disposition of remains. It carries no authority over your money, property, or bills. It also works differently than people sometimes assume: by default, your agent's authority to act does not begin until your clinician certifies, in writing and in your medical record, that you lack capacity to make your own decisions. Vermont law also lets you choose a different rule in the document itself, such as making it effective immediately upon signing, though most people use the default incapacity trigger. Vermont requires two witnesses to sign, with no notary option, and if you are in a nursing home, residential care facility, or hospital when you sign, an independent person such as an ombudsman or attorney must first explain the document to you. The Vermont Department of Health, through the Vermont Ethics Network, offers optional forms and a free statewide Advance Directive Registry where you can store your document so health care providers can find it.
Key Things to Know
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Vermont has no separate Medical Power of Attorney; instead, one document called an Advance Directive lets you (the principal) name a trusted adult (your agent) to make health care decisions if you become unable to decide for yourself, while also letting you record your own health care wishes in that same paperwork.
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Your agent's authority does not start the moment you sign by default. It begins only after your clinician certifies in writing, in your medical record, that you lack capacity, unless you specifically choose a different effective-date rule in the document itself (18 V.S.A. Sections 9702(a)(3)-(4), 9706).
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Unless you limit it, your agent can make any health care decision you could make yourself, including consenting to, refusing, or withdrawing treatment, and reviewing your medical records (Section 9711).
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Your agent cannot be your health care provider. Unless related to you by blood, marriage, civil union, or adoption, your agent also cannot be an owner, operator, employee, or contractor of a residential care facility, health care facility, or correctional facility where you live when you sign (Section 9702(c)).
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You need two witnesses, each at least 18 years old, who cannot be your agent, spouse, parent, adult sibling, adult child, or adult grandchild. Your own health care provider is allowed to be a witness. Vermont has no notary option for this document (Section 9703).
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If you are being admitted to, or are living in, a nursing home, residential care facility, or hospital when you sign, an ombudsman, attorney, clergy member, or similar independent person must explain the document to you first, or it is not effective (Section 9703(d)-(e)).
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You can revoke or suspend the document, or your agent's authority, at any time, regardless of your capacity, by signing a statement, telling your clinician, or destroying the document (Section 9704).
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Vermont maintains a free, statewide Advance Directive Registry where you can store your signed document so health care providers can find it (Section 9719).
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This is a different document from Vermont's Uniform Power of Attorney Act (14 V.S.A. Chapter 127), which covers property and financial decisions, not health care.
Key decisions before you file
Before you file a Healthcare Power of Attorney in Vermont, 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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Vermont Requirements for Healthcare Power of Attorney
The advance directive lets the principal appoint one or more agents, and specify the scope of their authority (18 V.S.A. Section 9702(a)(1)). The agent's actual scope and exercise of authority is governed separately by Section 9711, and the document is not always incapacity-triggered since the principal may elect a different effective-date rule under Section 9702(a)(3)-(4) and Section 9706.
The same subsection that permits appointing an agent also allows the principal to name one or more alternate agents who serve if the primary agent is unwilling, unable, or unavailable to act (18 V.S.A. Section 9702(a)(1)).
Section 9711 grants the agent authority to make any health care decision the principal could make, including consenting to or refusing any care, treatment, service, or procedure to maintain, diagnose, or treat a physical or mental condition, once the requirements for effectiveness in Section 9706 are met.
Federal HIPAA regulations govern how the agent can be authorized to access the principal's protected health information once the document is in effect.
By default, the agent's authority becomes effective only after the principal's clinician determines, and certifies in the medical record, that the principal lacks capacity (18 V.S.A. Section 9706(a)(1)). Vermont law also lets the principal elect a different rule in the document itself: a non-capacity-based triggering condition, or effectiveness immediately upon execution (Section 9702(a)(3)-(4)).
The principal's clinician determines incapacity after consulting an interested individual if reasonably available, makes specific findings on the cause, nature, and projected duration of the incapacity, and certifies the determination in the principal's medical record (Section 9706(a)(1), cross-referencing the capacity definition at Section 9701(4)).
The principal may direct which life-sustaining treatments, whether emergency, short-term, or long-term, and including medically administered nutrition and hydration, are desired or not desired, and may address a pregnancy-specific scenario separately (Section 9702(a)(7)-(8); definition at Section 9701(19)).
The principal may make, limit, or refuse to make an anatomical gift, and may separately appoint an individual to make or refuse an anatomical gift and arrange disposition of remains (Section 9702(a)(15), (18); definition at Section 9701(3)).
An advance directive may include a specific, separately executed provision granting the agent authority to consent to the principal's voluntary hospitalization, as part of a provision letting the agent authorize care over the principal's contemporaneous objection (Section 9707(h)(1)(E)). This provision requires its own witnessing and clinician-affirmation formalities under Section 9707(h).
The principal may suspend or revoke the advance directive, or the agent's designation, at any time and regardless of capacity, by signing a statement, by telling the clinician, or by destroying the document (Section 9704(b)(1)). Any provision other than the agent designation may also be revoked orally, in writing, or by any act evidencing intent, with or without capacity (Section 9704(b)(2)).
The principal signs before two or more witnesses who are at least 18 years old and who sign and affirm that the principal appeared to understand the document and was free from duress or undue influence (Section 9703(b)(1)). Since April 1, 2024, one witness may participate remotely by live audio-video or telephone under specific conditions (Section 9703(b)(2)).
Neither the agent appointed by the principal nor the principal's spouse, parent, adult sibling, adult child, or adult grandchild may witness the advance directive (Section 9703(c)).
An agent, guardian, or surrogate acting in good faith under an advance directive is not subject to criminal or civil liability for that decision (Section 9713(a)).
The principal may direct which life-sustaining treatment they would want or not want if they are pregnant at the time the advance directive becomes effective (Section 9702(a)(8)).
Unless the Probate Division of the Superior Court expressly orders otherwise in a guardianship proceeding, an agent's authority and the instructions in an advance directive executed before a guardian's appointment remain in effect, and the ward may not execute a new advance directive (Section 9711(g)).
Vermont law does not limit the enforceability of an advance directive or similar instrument validly executed in another state or jurisdiction under that jurisdiction's law, and an advance directive executed in Vermont is interpreted under Vermont law to the extent possible under conflicts-of-law principles (18 V.S.A. Section 9716).
Facilities that participate in Medicare and Medicaid must inform patients of their rights under state law to make advance directives.
When making a health care decision on the principal's behalf, the agent must consider the principal's known values or religious or moral beliefs (Section 9711(d)(1)(C)).
Frequently Asked Questions
An Advance Directive in Vermont is a legal document, created under Title 18, Chapter 231 of the Vermont Statutes, that lets you name a trusted adult (your agent) to make health care decisions for you and lets you record your own wishes about future medical care in the same document. By default, your agent's authority begins only after your clinician certifies in writing that you lack capacity to decide for yourself, though Vermont also lets you choose a different effective-date rule.
An Advance Directive covers only health care decisions, along with anatomical gifts and disposition of remains. Vermont's Uniform Power of Attorney Act (14 V.S.A. Chapter 127) covers property and financial matters instead, such as banking or real estate, and cannot authorize health care decisions. The two documents also default differently: the financial power of attorney is durable and effective immediately by default unless the document says otherwise, while the Advance Directive's agent authority defaults to waiting for a clinician's written incapacity certification unless the principal elects immediate effectiveness. Execution differs too: the financial power of attorney is signed with a notary acknowledgment and no statutory witness requirement, while the Advance Directive requires two witnesses and has no notary option at all.
Yes. Vermont law expressly allows a health care provider to serve as one of your two required witnesses (18 V.S.A. Section 9703(b)(3)). This is different from many other states, where a treating provider is barred from witnessing.
No. Vermont law bars your health care provider from acting as your agent, even though that same provider is allowed to serve as a witness to your signing (Section 9702(c)).
No. Vermont's Advance Directive statute has no notary option at all. The document is valid only if signed in the presence of two qualifying witnesses who are at least 18 years old (Section 9703). This is the reverse of Vermont's financial power of attorney, which relies on notary acknowledgment rather than witnesses.
If you are being admitted to, or are a resident or patient of, a nursing home, residential care facility, or hospital when you sign, the document is not effective unless an independent person, such as an ombudsman, a Vermont-licensed attorney, a member of the clergy, a Probate Division designee, or a similar qualified individual, first explains the document to you and signs a statement confirming that explanation (Section 9703(d)-(e)).
Yes. Vermont maintains the Vermont Advance Directive Registry, a free, secure, statewide database maintained by the Department of Health where you can submit your signed document so health care providers can access it when needed (Section 9719).
You can suspend or revoke your Advance Directive, or just your agent's designation, at any time, regardless of your mental capacity, by signing a statement, by telling your clinician (who must record it in your medical record), or by burning, tearing, or otherwise destroying the document yourself or through someone you direct in your presence (Section 9704).
Yes. Unlike some states, Vermont law lets you specify in the document itself that it becomes effective immediately upon signing, or that a different condition triggers your agent's authority, instead of the default rule that waits for your clinician to certify that you lack capacity (18 V.S.A. Sections 9702(a)(3)-(4), 9706).