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North Dakota Health Care Directive Form

A directive can name an agent, give health instructions, or both. The usual decision trigger is lack of capacity certified and placed in the medical record; the law permits express alternatives.

Jurisdiction
North Dakota
Purpose
Medical & health care
Source / form version
Undated legacy department form
Resource format
PDF
Signing
Date and sign, with a notary or at least two eligible adult witnesses verifying the signature. Both notary and witnesses must satisfy the statutory exclusions.
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Sources checked: 2026-11-13. General information, not individual legal advice.

Read the three-part document

This six-page department-hosted directive combines an agent appointment, treatment instructions and organ-donation choices. Part I names a primary and alternate decision maker. Part II gives room for values and treatment preferences. Read the completion notes before omitting a part, especially if choosing instructions without appointing an agent.

Sources: [2] [3]

Control the optional powers

The form distinguishes ordinary health-care powers from separately initialled choices about donation and disposition after death. It also provides room to restrict the agent’s authority. Discuss these choices with the agent before signing; an unmarked optional grant should not be assumed to apply merely because the person is your financial agent.

Sources: [2] [3]

Verify signatures and share the directive

Chapter 23-06.5 allows a notary or two witnesses, but excludes the agent, specified family and estate interests, the attending physician and other listed people. With witnesses, at least one must be outside the direct-care provider or its employees. Give the completed directive to the agent and provider; tell them about any later replacement or revocation. Check addresses and phone numbers for both agents and keep the personal instructions attached. Review the document again after a major change in health or availability.

Sources: [2] [3]

Common questions

Must I appoint an agent?

A directive may consist of health instructions, an appointment, or both. Follow the form’s instructions for the parts you choose.

Sources: [2] [3]

Can my spouse witness or notarize it?

The current statute excludes the principal’s spouse and other specified relatives from serving as witness or notary for execution.

Sources: [2] [3]

Related forms and guides

Sources and verification

  1. North Dakota Department of Human Services, legacy policy-manual attachment: source and instructions (opens in a new tab)
  2. Published form (opens in a new tab)
  3. North Dakota Century Code Chapter 23-06.5 (opens in a new tab)

Exact legacy policy attachment recovered after former /info/docs/hcdirective.pdf returned 404. Six-page PDF downloaded and text inspected; current statute used for execution and authority rules. No claim that the old attachment was revised in 2026.

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.