Free Vermont Advance Directive Form

A Vermont advance directive brings several important decisions together in one document. It allows you to name a decision-maker, give medical treatment instructions, and record personal or end-of-life preferences that health care providers can follow when needed.

1. Naming a Health Care Agent

You can appoint a health care agent to make medical decisions for you once your directive takes effect. Your agent can make the same health care decisions you’d make yourself (18 VT Stats § 9711(a)). Vermont law lets you:

• Name one or more agents and backup (alternate) agents (18 VT Stats § 9702(a)(1))
• Decide when your agent’s authority starts or ends, such as after loss of capacity or another condition you choose (18 VT Stats § 9702(a)(3))
• Have the directive take effect right away if you state that choice (18 VT Stats § 9702(a)(4))

You stay in control of your medical care while you have decision-making capacity. If the directive is in effect, your agent may also act, but you have the final say. Once you lose capacity, your agent has full authority (18 VT Stats § 9711(b)).

Who Can You Name?

Vermont law places a few limits on who may serve as your agent:

• The person has to be an adult with decision-making capacity (18 VT Stats § 9701(2))
• Your health care provider usually isn’t allowed to serve unless they’re related to you
• Owners or employees of facilities where you receive care are generally restricted unless they’re family members (18 VT Stats § 9702(c))

How Your Agent Makes Decisions

When acting for you, your agent follows your wishes in this order:

• Your written instructions
• Your known preferences, values, or religious beliefs
• Your best interests if your wishes aren’t known (18 VT Stats § 9711(d))

2. Instructions for Your Medical Care

A Vermont advance directive lets you give clear guidance about medical treatment. You can:

• Accept or refuse medical treatment or hospitalization (18 VT Stats § 9702(a)(5))
• Give directions about life-sustaining treatment
• Address medically administered nutrition and hydration (18 VT Stats § 9702(a)(7))
• Include pregnancy-specific instructions (18 VT Stats § 9702(a)(8))
• Allow health care providers to share medical information with chosen individuals (HIPAA authorization) (18 VT Stats § 9702(a)(11))
• Add instructions for future medical situations or personal circumstances (18 VT Stats § 9702(a)(12))

3. End-of-Life and Personal Instructions

An advance directive can also cover personal and post-death planning decisions, including:

• Naming a preferred clinician (18 VT Stats § 9702(a)(13))
• Nominating a future guardian if needed (18 VT Stats § 9702(a)(14))
• Making or refusing anatomical gifts or organ donation (18 V.S.A. § 9702(a)(15))
• Giving directions for disposition of remains and funeral goods or services (18 VT Stats § 9702(a)(16) – (18))

With Legal Templates, you can include all of these decisions in one Vermont advance directive and download a ready-to-sign form.

A Vermont advance directive can be signed by any adult who has decision-making capacity. You can complete and sign the document at any time, as long as you understand what you’re signing and are making the decision voluntarily (18 VT Stats § 9703(a)).

1. Complete and Date the Directive

Fill out the advance directive and add the date before signing. The document should match your wishes at the time you complete it (18 VT Stats § 9703(b)).

2. Sign the Document

Sign the directive yourself. If you’re physically unable to sign, you can direct another person to sign for you while you’re present (18 VT Stats § 9703(b)).

3. Have Two Adult Witnesses Present

Two adult witnesses need to watch you sign the directive. They confirm that you understand what you’re signing and that you’re doing so willingly, without pressure or duress (18 VT Stats § 9703(b)(1)).

4. Make Sure Your Witnesses Are Eligible

Some people aren’t allowed to serve as witnesses. Your health care agent and certain close family members generally shouldn’t act as witnesses under Vermont law (18 VT Stats § 9703(c)).

5. Sign Remotely or Electronically

Vermont allows remote witnessing when legal requirements are met. Digital signatures are also valid, which makes signing easier if meeting in person isn’t possible (18 VT Stats § 9703(b)(2), (g)).

View a sample Vermont advance directive to see how the document works. When you’re ready, customize your form and download it in Word or PDF format.

You can register a Vermont advance directive through the state’s free Vermont Advance Directive Registry (VADR). Registration isn’t required for the document to be legally valid. Your directive takes effect once it’s properly signed and witnessed.

The registry securely stores your directive. Health care providers can access it if you’re unable to communicate during an emergency (18 VT Stats § 9719).

You can register your directive in one of the following ways:

• Create an online account and upload a PDF copy, or
• Mail, email, or fax a copy of the registry authorization form

Health care providers and facilities may check the registry when treating a patient who lacks decision-making capacity (18 VT Stats§ 9709). You can update or replace your directive at any time by submitting a new copy.

A Vermont advance directive takes effect when the conditions listed in the document are met or when a clinician determines you’re no longer able to make your own medical decisions. Depending on how your directive is written, it may take effect in one of the following situations:

• A clinician determines you lack decision-making capacity and records that decision in your medical records (18 VT Stats § 9706(a)(1), (b))
• A situation you listed in the directive occurs, such as a specific medical condition or event (18 VT Stats9702(a)(3); § 9706(a)(2))
• The directive states that it becomes effective as soon as it’s signed (18 VT Stats § 9702(a)(4); § 9706(a)(3))

If there’s ever a question about capacity, your directive can be reviewed again. If you regain capacity, your health care agent steps back, and you retake control of your medical decisions (18 VT Stats §§ 9706(c), 9711(c)). Instructions about the disposition of remains take effect at death rather than during medical treatment (18 VT Stats § 9706(e)).

Yes. You can change or cancel a Vermont advance directive at any time, as long as you still have decision-making capacity (18 VT Stats § 9703(a)). The easiest way to make a change is to complete a new advance directive. In most cases, the latest document replaces earlier versions and guides future medical decisions.

Once health care providers know about an update, suspension, or cancellation, they’re required to follow the most recent directive (18 VT Stats § 9709(b)). If there’s ever a dispute about whether a directive is valid or properly revoked, the Vermont Probate Division can step in and decide (18 VT Stats § 9718).