Arizona Healthcare Directives Registry (AzHDR): How to Register and Who Can Access Your Documents

Why the Registry Exists

Completing your advance directives is only half the job. If emergency responders cannot find your documents during a cardiac event at 2 AM, or a hospital cannot confirm your Healthcare POA during an unexpected admission, your carefully executed forms serve no purpose.

The Arizona Healthcare Directives Registry (AzHDR) solves this by storing digital copies of your directives in a secure electronic system accessible to any participating hospital, emergency department, or EMS team in Arizona — 24 hours a day, 7 days a week.

Who Operates It Now

This causes significant confusion. The registry was originally administered by the Arizona Secretary of State. Following Senate Bill 1352, the Arizona Department of Health Services designated Contexture — the state's nonprofit health information exchange — as the registry operator.

The Secretary of State's office no longer processes advance directives. The Arizona Attorney General's office distributes blank forms but does not accept or store completed ones. Filing goes exclusively through Contexture at azhdr.org.

How to Register Your Documents

The registration process:

1. Complete the Consumer Registration Agreement — a separate form from your advance directives themselves. Available through the AG's Life Care Planning Packet or from Contexture directly.

2. Notarize the agreement — required if you submit by mail or fax. This verifies your identity and prevents unauthorized submissions. If a healthcare provider uploads your documents directly through their electronic portal, notarization of the agreement is not required because the provider verifies your identity.

3. Submit photocopies — never originals. Contexture scans and digitally uploads your documents, then shreds all physical paperwork. Mail or email legible photocopies of your executed Healthcare POA, Living Will, Mental Health POA, and any DNR/POLST forms.

4. Receive your wallet card — Contexture sends you a card with login credentials and a unique access code. Carry this alongside your health insurance card.

Who Can Access Your Records

Participating hospitals and emergency departments can look up your directives electronically when you present at their facility. Hospital social workers can also retrieve and confirm documents during admissions.

Emergency personnel responding to a home call can use the access code on your wallet card to pull your documents on a mobile device at the scene.

Your designated healthcare agent should know your registry access code so they can direct medical staff to your documents if you arrive unconscious.

Updating Registered Documents

Directives should be reviewed every two to three years or after major life events. To update:

1. Execute new forms using proper witness or notary procedures
2. Complete a new AzHDR Registration Agreement
3. Check the box indicating you are replacing or revoking an existing document
4. Submit the new set to Contexture

The registry software automatically identifies the most recently dated document as the active version. Older versions are superseded but retained for the historical record.

Common Registration Mistakes

• Sending originals instead of photocopies (Contexture shreds everything received)
• Forgetting to notarize the Registration Agreement for mail/fax submissions
• Assuming the AG's office or Secretary of State handles filing
• Not updating the registry after executing new or revised directives
• Failing to carry the wallet card or share the access code with your agent

The Full Workflow

Registration is the final step in a multi-document process: draft your Healthcare POA, Living Will, and Mental Health POA; execute them with proper witnesses or notary; then submit everything to AzHDR. The Arizona Advance Directive & Living Will Kit walks you through each stage sequentially, including the exact submission steps and a pre-submission checklist to confirm everything is registry-ready before you mail it.

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