Guides · State guides · Vermont
Advance Directive in Vermont: Health Care Agent, Witnesses and the Registry
Vermont uses one document, the advance directive, to name a health care agent and record treatment wishes. It needs two adult witnesses and no notary, and close family can't witness it. Here is how it works under 18 V.S.A. chapter 231.
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What to know
- A Vermont advance directive must be dated and signed by your parent and by two or more witnesses at least 18 years old; the signing section, 18 V.S.A. § 9703, doesn't require a notary.
- The agent, and your parent's spouse, parent, adult sibling, adult child or adult grandchild, can't be a witness. A health care provider can.
- Signing in a nursing home, residential care facility or hospital needs an extra step: someone from a list in the statute must first explain the document to your parent.
- Without an agent or guardian, Vermont's advance directive law lets a family surrogate decide only about DNR and COLST orders, and lets family elect hospice; broader decisions can mean guardianship.
- Retirement Checklist puts these documents in order alongside everything else your family needs to settle.
A Vermont advance directive is one document, under 18 V.S.A. chapter 231, that can name a health care agent and record treatment wishes, and it needs two adult witnesses but no notary. The statute defines it as "a written record executed pursuant to section 9703 of this title, which may include appointment of an agent, identification of a preferred primary care clinician, instructions on health care desires or treatment goals, an anatomical gift, disposition of remains, and funeral goods and services" (18 V.S.A. § 9701). The Vermont Department of Health puts it plainly: "An advance directive is what many people think of as a living will or a durable power of attorney for health care."
What does a Vermont advance directive cover?
It can name an agent, give treatment instructions, nominate a guardian, and cover anatomical gifts and funeral wishes, all in one document under 18 V.S.A. § 9702:
| Part | What it does | Statute |
|---|---|---|
| Appointment of an agent | Names one or more agents and alternates to make health care decisions | 18 V.S.A. § 9702(a)(1) |
| Treatment instructions | States the care your parent wants or doesn't want, including life sustaining treatment | 18 V.S.A. § 9702(a)(5), (7) |
| Guardian nomination | Names who should be guardian if one is ever needed | 18 V.S.A. § 9702(a)(14) |
| Gifts and remains | Anatomical gifts, disposition of remains and funeral wishes | 18 V.S.A. § 9702(a)(15) to (18) |
Older documents still count. The definition "includes documents designated under prior law as a durable power of attorney for health care or a terminal care document," and those stay valid if they met the law when signed. A financial power of attorney is separate and doesn't cover health care; see our Vermont power of attorney guide. For the general picture, see power of attorney vs. advance directive.
How do you sign a Vermont advance directive?
Under 18 V.S.A. § 9703, the document "shall be dated, executed by the principal or by another individual in the principal's presence at the principal's express direction if the principal is physically unable to do so, and signed by two or more witnesses at least 18 years of age." The witnesses affirm that your parent "appeared to understand the nature of the document and to be free from duress or undue influence."
Who can't witness: "Neither the agent appointed by the principal nor the principal's spouse, parent, adult sibling, adult child, or adult grandchild may witness the advance directive." The statute expressly allows a health care provider to be a witness. No notary is required by § 9703.
Since April 1, 2024, a witness can take part remotely if your parent and the witness know each other, the witness attests over a live audio-video connection or by telephone, and your parent writes the remote witness's name, contact information and relationship on the document. Digital signatures are allowed.
What extra step applies in a nursing home or hospital?
An advance directive "shall not be effective" if, when it's signed, your parent is being admitted to or lives in a nursing home or residential care facility, unless someone from a list in 18 V.S.A. § 9703(d) explains the document to your parent and signs a statement saying so. The list includes an ombudsman, "a recognized member of the clergy," "an attorney licensed to practice in this State," a Probate Division designee, and a clinician who isn't employed by the facility.
The same rule applies to a parent being admitted to or staying in a hospital, with a shorter list that includes the ombudsman, clergy, a Vermont attorney and an individual the hospital designates. The explanation can be given in person, by live video or by telephone, and the person who explains it may also be one of the witnesses.
Who can't be the health care agent?
Under 18 V.S.A. § 9702(c), "The principal's health care provider may not be the principal's agent." Unless related to your parent by blood, marriage, civil union or adoption, an agent also can't be an owner, operator, employee, agent or contractor of a residential care facility, health care facility or correctional facility where your parent lives when the document is signed.
Family members can serve. If your parent names more than one agent, a clinician can rely on one of them after documenting that all agree, or that the others aren't reasonably available.
When does the agent start making decisions?
Unless your parent chose otherwise, it takes effect when their clinician determines, "after speaking with an interested individual if one is reasonably available, that the principal lacks capacity," records findings about the cause and likely duration, and tries to notify your parent and the agent (18 V.S.A. § 9706). Your parent can instead choose a specific condition, or make it effective as soon as it's signed.
The agent then has authority to make "any health care decisions on the principal's behalf that the principal could make if the principal had capacity," and must try to decide "what the principal would have wanted under the circumstances." While your parent still has capacity, they keep concurrent authority, and if they disagree with the agent, "the decision of the principal shall be controlling." The agent's authority stops when a clinician finds your parent has recovered capacity.
Where do you get Vermont advance directive forms?
The Vermont Department of Health lists free forms: an Appointment of a Health Care Agent Form, a short-form advance directive and a long-form advance directive. It notes, "You can also choose one from another organization of your choice. Vermont law does not favor one over another." Under 18 V.S.A. § 9717, a properly signed directive "shall be presumed valid," and no third party may require a different form.
Under 18 V.S.A. § 9719, the Commissioner of Health maintains a registry, the Vermont Advance Directive Registry, and providers must have protocols to check it when someone without capacity is admitted. The Department of Health says registration "is free for all Vermont residents," and "You are not required to register a copy of your advance directive, and your directive is valid as soon as signing and witnessing is properly completed."
What happens if your parent has no advance directive?
Family members get a limited role: Vermont's advance directive law lets a surrogate decide only about DNR and COLST orders, and lets family elect hospice. Under 18 V.S.A. § 9731, a surrogate can consent to or refuse only a do-not-resuscitate order or a clinician order for life-sustaining treatment (COLST), and only when your parent lacks capacity, has no agent and no authorized guardian, and doesn't object. The surrogate is an "interested individual": a spouse, adult child, parent, adult sibling, adult grandchild or clergy person, or another adult who has shown special care and concern and knows your parent's values.
There's no ranked order. Your parent can name a surrogate by telling the clinician; otherwise the interested individuals have to agree. "If at any time the interested individuals are unable to agree on the designation of a surrogate," an interested person may petition the Probate Division for guardianship. Separately, a family member or someone close may elect hospice care if there's no agent or guardian available. Chapter 231 doesn't give family authority over other treatment decisions; see conservatorship and guardianship.
How do you revoke a Vermont advance directive?
Under 18 V.S.A. § 9704, your parent, "with or without capacity," can suspend or revoke all or part of an advance directive, including the agent's appointment, in three ways:
- by signing a statement suspending or revoking it;
- by personally telling their clinician, who records it in the medical record;
- by burning, tearing or obliterating the document, or having someone do so at their direction and in their presence.
Other instructions can also be revoked orally. With capacity, your parent can make changes by signing a new advance directive with two witnesses. Filing for divorce, annulment, dissolution of a civil union or legal separation suspends a spouse's appointment as agent unless the document or court says otherwise, and it becomes permanent when the case is final. If the directive is registered, the Department of Health asks for a written statement and its change form.
What about DNR and COLST orders?
A DNR order or COLST is a medical order signed by your parent's clinician on the Department of Health's "Vermont DNR/COLST form." The Department says "DNR/COLST orders are not advance directives," and emergency responders "cannot withhold any treatments unless there is a DNR/COLST order in place and clearly displayed." It also says portable orders "properly completed in another state will be honored in Vermont."
Frequently asked questions
Does an advance directive need to be notarized in Vermont?
No. 18 V.S.A. § 9703 requires the document to be dated and signed by your parent and by two or more witnesses at least 18 years old; it doesn't require a notary. Your parent signs in the witnesses' presence, or with a remote witness who meets the conditions in the statute.
Can a family member witness a Vermont advance directive?
Not close family. The agent, and your parent's spouse, parent, adult sibling, adult child or adult grandchild, can't witness it. The statute doesn't bar other relatives or friends, and it expressly allows a health care provider to witness. In a nursing home or hospital, the person who explains the document may also be a witness.
Where can I get a Vermont advance directive form?
The Vermont Department of Health lists free forms: an Appointment of a Health Care Agent Form and short and long advance directive forms, along with forms in other languages. It says Vermont law doesn't favor one form over another, and a properly signed directive is presumed valid whatever form it uses.
Who makes medical decisions in Vermont if there's no advance directive?
Vermont's advance directive law lets a family surrogate decide only about DNR and COLST orders, and lets family elect hospice when there's no agent or guardian. If interested family members can't agree on a surrogate, or broader decisions are needed, the route is a guardianship petition in the Probate Division.
Is an advance directive from another state valid in Vermont?
Yes, if it complied with that state's law. Under 18 V.S.A. § 9716, nothing in Vermont's chapter "limits the enforceability of an advance directive or similar instrument executed in another state or jurisdiction in compliance with the law of that state or jurisdiction." Out-of-state DNR orders are honored in good faith if there's no reason to doubt them.
Can my parent change their mind after signing?
Yes. Your parent can revoke all or part of it, even without capacity, by a signed statement, by telling their clinician, or by destroying it. While your parent has capacity, their decision controls if they disagree with the agent. Giving the clinician and the registry the new document keeps records current.
Getting started
An advance directive only helps if it's signed while your parent can sign it, with two witnesses who aren't the agent or close family. Without one, Vermont's advance directive law gives family a say only over DNR and COLST orders and hospice. The plan this site builds asks four questions, including which state your parents live in, and puts the steps that matter most for your family in order. It's free and takes about 90 seconds.
Related guides
Sources
- 18 V.S.A. chapter 231, Advance Directives for Health Care, Disposition of Remains, and Surrogate Decision Making: definitions (9701), contents and agent limits (9702), signing (9703), revocation (9704), when it's effective (9706), DNR and COLST (9708), hospice consent (9710), agent's authority (9711), out-of-state documents (9716) and surrogate consent (9731); published by the Vermont General Assembly.
- Vermont Department of Health, Create, register and make changes to an advance directive: the free forms and the registry.
- Vermont Department of Health, DNR/COLST: the DNR/COLST form and how orders are used.
More on what this tool does and doesn't do, or browse everything we've written.