Alaska Advance Directive Form: Requirements, Execution, and Common Mistakes

Hospital intake staff reject improperly executed advance directives every week in Alaska — and the consequences during a medevac emergency from a bush village to Anchorage can be devastating. Getting the form right the first time matters more here than in any other state.

Alaska's advance health care directive (AHCD) under AS 13.52 is a single five-part document that covers healthcare agent designation, living will instructions, organ donation, mental health treatment preferences, and primary physician designation. Here's exactly what you need to complete it correctly.

What the Alaska AHCD Covers

The statutory form under AS 13.52.010 combines five sections into one instrument:

• Part I — Durable Power of Attorney for Health Care: Names your primary agent, first alternate, and second alternate to make medical decisions if you lose capacity.
• Part II — Living Will Instructions: Documents your preferences on life-sustaining treatment, artificial nutrition, hydration, and comfort care.
• Part III — Anatomical Gift at Death: Records organ, tissue, or whole-body donation wishes.
• Part IV — Mental Health Treatment Declaration: Covers psychotropic medications, electroconvulsive therapy, and short-term psychiatric admission preferences.
• Part V — Primary Physician Designation: Names the doctor responsible for overseeing your care and determining capacity.

You can complete all five parts or only the sections relevant to you. Each completed section is independently enforceable.

How to Make It Legally Valid

Under AS 13.52.010, your directive must be in writing, dated, signed by you (or someone signing at your direction), and validated through one of two methods:

Option A — Two adult witnesses. Both witnesses must be at least 18, personally know you, and watch you sign. Neither witness can be your designated healthcare agent, your treating provider, or an employee of your healthcare facility. At least one witness must be completely disinterested — not related by blood, marriage, or adoption, and not entitled to any part of your estate.

Option B — Notary public. A licensed notary acknowledges your signature. Alaska authorized Remote Online Notarization (RON) on January 1, 2021, under House Bill 124 — critical for rural families without local notary access. The notary must be physically located in Alaska during the video session.

One important exception: if your directive includes body disposition instructions under AS 13.75.010, notarization is mandatory regardless of which method you use for the rest of the document.

Common Execution Mistakes

Three errors cause the most rejections:

1. Using your healthcare agent as a witness. AS 13.52.010(d) explicitly prohibits this, but it happens constantly when families sign documents together at the kitchen table.
2. Both witnesses related to you. At least one must be completely independent — no family connection and no inheritance interest.
3. Missing the date. The statute requires the date of execution. An undated directive creates legal ambiguity about which document controls if you've signed multiple versions.

Out-of-State Portability

Under AS 13.52.010(k), Alaska recognizes advance directives executed in other states, provided they align with the intent of the Health Care Decisions Act. Alaska's stricter witness requirements also mean a properly executed Alaska AHCD travels well — most other states will accept it.

If you split time between Alaska and the Lower 48, keep copies filed with providers in both locations. Tribal health organizations using integrated EHR systems can scan your directive into a universally accessible folder, ensuring receiving hospitals see it before your medevac flight lands.

What Happens Without One

When no directive exists, Alaska's surrogate hierarchy under AS 13.52.030 kicks in: spouse first, then adult children, parents, adult siblings, and finally any adult who has shown "special care and concern." If adult children disagree and split evenly, the entire class is disqualified and your primary physician makes the call.

That default process works — but it's slow, stressful, and guarantees family conflict during the worst possible moment.

The Alaska Advance Directive & Living Will Kit walks you through every section of the statutory form with step-by-step instructions, witness screening tools, and a distribution checklist designed for Alaska's rural healthcare reality.

See more Alaska guides →