Five Wishes vs. Arizona State Advance Directive Forms: Which One Do You Need?

Five Wishes Is Legally Valid in Arizona — With Gaps

Five Wishes, published by Aging with Dignity, is recognized as a legal advance directive in Arizona. It meets the basic statutory requirements for appointing a healthcare agent and documenting treatment preferences. If you've already completed Five Wishes and had it properly witnessed, it carries legal weight in Arizona hospitals.

But "legally valid" and "comprehensive for Arizona's system" aren't the same thing. Five Wishes was designed as a national, values-based document. Arizona's healthcare directive framework has specific features that Five Wishes doesn't address — and those gaps can create real problems during a crisis.

What Five Wishes Covers Well

Five Wishes walks you through five planning domains in plain, compassionate language:

1. Who you want to make healthcare decisions for you
2. What medical treatments you do or don't want
3. How comfortable you want to be (pain management)
4. How you want people to treat you (dignity preferences)
5. What you want your loved ones to know

For emotional preparation and values clarification, Five Wishes is excellent. It helps people who freeze up at "medical power of attorney" and "living will" actually think through what matters to them. The conversational format breaks through the intimidation barrier that stops many families from planning at all.

What Five Wishes Doesn't Cover in Arizona

The Separate Mental Health POA

Arizona requires a completely separate Durable Mental Health Care Power of Attorney (A.R.S. § 36-3282) for psychiatric care decisions. This includes authority over psychiatric medication, electroconvulsive therapy, and — critically — inpatient psychiatric admission (which requires the principal to separately initial a specific statutory paragraph).

Five Wishes names a healthcare agent, but that agent has no psychiatric authority unless a separate MHPOA is executed under Arizona law. For anyone with a history of depression, bipolar disorder, PTSD, or dementia-related behavioral symptoms, this gap matters.

The Orange-Paper Prehospital DNR

If you want emergency responders (paramedics, EMTs) to honor a Do Not Resuscitate order outside of a hospital, Arizona requires a Prehospital Medical Care Directive printed on orange paper under A.R.S. § 36-3251. Five Wishes has no equivalent. Its treatment refusal language applies to hospital settings, not prehospital emergency situations where first responders must follow specific statutory forms.

Without the orange-form DNR, EMTs must perform full resuscitation regardless of what Five Wishes says.

The AzHDR Registry

Arizona's electronic Healthcare Directives Registry (AzHDR), operated by Contexture, allows hospitals and emergency departments to access your directives digitally in real time. Registering requires a separate Consumer Registration Agreement with a notarized signature.

Five Wishes doesn't include AzHDR registration guidance or the submission forms. If you complete Five Wishes but don't register it, your document sits in a drawer at home while the ER has no electronic record to check.

The Beneficiary Deed and Real Estate Protection

Arizona is a community property state, and real property transfer is a key part of end-of-life planning here. The Beneficiary Deed (A.R.S. § 33-405) bypasses probate for your home — but it's a separate legal instrument with its own execution and recording requirements. Five Wishes doesn't touch property planning.

Funeral Disposition Authority

If you want your healthcare agent to also handle funeral and cremation arrangements, Arizona law requires either notarization or two witnesses (higher than the standard one-witness threshold). Five Wishes doesn't include this authority or explain the elevated execution requirement.

Do You Need Both?

If you've already completed Five Wishes: Keep it. It serves as your Living Will and Healthcare POA (Wishes 1 and 2 cover these). But you still need:

• A separate Arizona Mental Health POA (if psychiatric authority matters to you)
• A Prehospital DNR on orange paper (if you want pre-hospital DNR coverage)
• AzHDR registration (so hospitals can access your documents electronically)
• A Beneficiary Deed (if you own property and want to avoid probate)

If you haven't started yet: You can use Five Wishes as a values-clarification tool to figure out what you want, then execute Arizona-specific forms that cover the full scope. Or use an Arizona-specific kit that integrates the values conversation with the state's execution requirements from the start.

The Execution Detail

Five Wishes meets Arizona's execution requirements if signed in the presence of one notary public or one qualifying witness (same restrictions as any Arizona advance directive: witness can't be your agent, can't be related, can't be a healthcare provider, can't be an estate beneficiary if they're the sole witness).

If your Five Wishes document was witnessed by your spouse or adult child as the sole witness, it's invalid under Arizona law — even though Five Wishes' own instructions may suggest otherwise.

The Arizona Advance Directive & Living Will Kit addresses all five of these Arizona-specific gaps in one integrated package, including the Clinical Values Matrix (the deeper version of what Five Wishes' values questions accomplish), execution checklists, and the separate statutory forms that Five Wishes can't replace.

See more Arizona guides →