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Georgia Advance Directive for Health Care Form

Appoints an agent, records treatment preferences, and optionally nominates a guardian; each completed part works as directed by the form.

Jurisdiction
Georgia
Purpose
Medical & health care
Source / form version
Revised May 2010; still linked by the department.
Resource format
PDF
Signing
Sign and date with two qualified adult witnesses. Notarization is not required. Witness eligibility restrictions appear in Part Four.
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Sources checked: 2026-11-13. General information, not individual legal advice.

Choose the parts you need

Georgia’s combined advance directive has four parts: health care agent, treatment preferences, guardianship, and execution. Part One can be used even if Part Two is not completed. Conversely, treatment wishes do not themselves appoint someone to make every health care decision. Read the explanatory pages before selecting the parts that serve your goals.

Sources: [1] [3]

Discuss the instructions with your agent

Name the primary agent and any backups, then explain the treatments and values that matter to you. The treatment section addresses specified serious conditions and includes space for additional instructions. A guardian nomination is optional and is different from giving a health care agent immediate day-to-day financial authority.

Sources: [1] [3]

Finish Part Four

The directive needs the principal’s signature and two qualified adult witnesses. The form excludes the named agent and people with specified inheritance or direct-care conflicts; no more than one witness may be an employee, agent, or medical-staff member of the treating facility. Read the declarations before choosing witnesses. Notarization is unnecessary, and copies of a validly executed directive have the same effect as the original.

Sources: [1] [3]

Common questions

Can I appoint an agent without completing treatment preferences?

Yes. The form expressly permits Part One to be effective without Part Two, provided the execution section is completed.

Sources: [1] [3]

Should I use the financial POA for this appointment?

Use the health care directive for medical authority. Georgia’s statutory financial packet and this directive serve different purposes and have different execution instructions.

Sources: [1] [3]

Related forms and guides

Sources and verification

  1. Georgia DHS Division of Aging Services: source and instructions (opens in a new tab)
  2. Direct PDF (opens in a new tab)
  3. Georgia Attorney General — advance directives (opens in a new tab)

Primary publisher file and instructions checked on 2026-11-12. External link only; no independent attorney review or suitability determination is claimed.

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.