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North Carolina Health Care Power of Attorney and Advance Directive

Part A appoints an agent to act when the principal cannot make health care decisions; Part B records separate treatment directions.

Jurisdiction
North Carolina
Purpose
Medical & health care
Source / form version
Revised June 2025, printed on the form.
Resource format
PDF
Signing
Sign and date with two qualified witnesses and a notary present; complete all three sections of Part C.
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Sources checked: 2026-11-13. General information, not individual legal advice.

Choose Part A, Part B, or both

Duke’s practical North Carolina directive permits an agent appointment, a living will, or both. To appoint a medical decision maker, complete Part A and name a backup if desired. An agent must be a competent adult and cannot be your paid health care provider. Keep all five pages together even when not using every part.

Sources: [1] [3] [4]

Resolve how instructions and the agent interact

Part A allows limits on the agent and a separate organ-donation authorization. Part B asks whether the living will or the agent’s decision should control if they differ. Initial only one of those alternatives. Discuss your choices with the agent and clinician so that treatment instructions are usable rather than contradictory.

Sources: [1] [3] [4]

Arrange witnesses and notarization together

Part C requires the principal’s signature, two witness signatures, and notarization. The witnesses must satisfy the declarations about relatives, inheritance, claims against the estate, and specified care-provider relationships. Wait until the witnesses and notary are present before signing. Share the complete executed document with the agent, backup, and providers, and keep the original accessible.

Sources: [1] [3] [4]

Common questions

Can I appoint an agent without making a living will?

Yes. The instructions permit Part A alone. Follow the directions for striking through unused parts and complete Part C.

Sources: [1] [3] [4]

Is this the Secretary of State’s PDF?

No. This is Duke Health’s June 2025 practical form, linked from its current advance-directive page. It is clearly identified as a health-system resource.

Sources: [1] [3] [4]

Related forms and guides

Sources and verification

  1. Duke Health: source and instructions (opens in a new tab)
  2. Direct PDF (opens in a new tab)
  3. G.S. 32A-16 — definitions and witnesses (opens in a new tab)
  4. G.S. 32A-20 — effectiveness and revocation (opens in a new tab)

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The date above records a source check. It does not certify that a form is suitable for your circumstances or that an attorney has reviewed your document. Read the publisher’s current instructions before use.