Free Maryland Advance Directive Form

The sensitive nature of an advance directive makes it important to ensure full and accurate terms. A Maryland advance directive requires you to include details about you, your agent, and your medical wishes, per MD Health – General Code § 5-603.

1. Declarant Information

hjuWhen creating your own advance directive, record yourself as the declarant, or the one who receives medical care. Include your full legal name and address to verify your identity and form.

Typically, the declarant writes their own advance directive; however, a third party may prepare it at the declarant’s direction if needed.

2. Agent Selection

In an advance directive, you can select a health care agent to carry out your written wishes. Provide the full name, phone number, and address of your agent. Consider who you trust to act on your behalf and ensure they are willing to serve as your agent. You can also name an alternate agent for a backup if your chosen agent is unable or unwilling to act.

Under MD Health – Gen Code § 5-602, an agent cannot be the owner, operator, or employee of the health care facility where the declarant is receiving treatment. Any spouse, parent, child, or sibling of the owner, operator, or employee is also unable to serve as an agent.

3. Agent Authorities

Once you’ve named the agent, you can set their authorities and limitations. Customize your form and write in any desired restrictions or specific guidelines. Also, select whether medical providers have consent to release your health care records to the agent as necessary.

If a physician refuses to comply with any instruction from your agent, they must inform the agent and make reasonable efforts to transfer you to another health care provider (MD Health – General Code § 5-613).

4. Treatment Preferences

The treatment preferences section of a Maryland advance directive works the same as a living will. In this section, you can list and communicate which life-sustaining treatments you do or do not wish to receive. Provide your preferences regarding intubation, ventilation, artificial hydration or nutrition, and pain relief. Also consider including a do-not-resuscitate order (DNR) based on your desired care.

Note that your advance directive will only go into effect if a physician and a second physician or a nurse practitioner who has seen you within the previous 2 hours certify in writing that you cannot make decisions for yourself (MD Health – General Code § 5-606).

Legal Templates’s free Maryland advance directive ensures your end-of-life care preferences are respected. Use our customizable form, available in PDF and Word format, for easy recording and communication.

Maryland state laws govern the formatting, filing, and updating of advance directives. Evaluating the legal considerations for your advance directive ensures proper validity and enforceability.

Signing

MD Health Gen Code § 5-602 requires that every advance directive have the signatures of two witnesses to be considered valid. Witnesses can sign in your presence, whether in person or electronically.

Your health care agent may not serve as a witness. At least one witness must not benefit from your estate.

While notarization is not required, having a notary’s signature makes your form easier to verify and enforce. Finally, ensure the declarant also signs, or that a representative signs on their behalf and at their direction.

Recording

While you aren’t required to record your Maryland advance directive, you should make it accessible to your agent and medical providers by providing them with copies.

It’s optional, but you may also consider recording your Maryland advance directive with the Chesapeake Regional Information System for our Patients (CRISP). Recording it here allows medical providers across the state to have immediate access to your wishes in an emergency.

Revocation

If at any point you want to change or revoke the terms of your Maryland advance directive, you can do so. Under MD Health Gen Code § 5-604, the declarant may write and deliver a revocation form to the agent at any time. A verbal statement given to your health care provider also counts as a valid revocation. State laws also allow the creation of a subsequent advance directive to revoke the current agreement terms.

Without a Maryland advance directive, the state allows a surrogate decision maker to act on your behalf. Per MD Health Gen Code § 5-605, the following individuals may be able to make health care decisions and receive authority in this order of priority:

1. A guardian for the patient, if one has been appointed
2. The patient’s spouse or domestic partner
3. An adult child of the patient
4. A parent of the patient
5. An adult brother or sister of the patient
6. A friend or other relative of the patient

A friend or relative not listed above may also receive permission to act as an agent if they are a competent individual and provide the physician with an affidavit stating their relation and evidence of recent contact and knowledge of the patient’s beliefs and wishes.