How to Complete a New Hampshire Advance Directive Without a Lawyer

You don't need an attorney to complete a legally valid advance directive in New Hampshire. RSA 137-J explicitly permits any competent adult to create their own Durable Power of Attorney for Health Care (DPOAH) and Living Will — the two components of New Hampshire's combined advance directive form. What you do need is the correct execution process: two qualified witnesses (or one notary), an understanding of the nine witness disqualification categories, and knowledge of the 2021 SB 74 update that most online templates haven't incorporated.

Here's the complete process, the execution requirements that trip people up, and the supplemental documents the free state form doesn't include.

The Five Steps

1. Choose Your Healthcare Agent (DPOAH)

Your agent is the person who makes medical decisions when you can't. Under New Hampshire's 2021 SB 74 update, your agent receives "broadened default authority" — including the power to implement a POLST, consent to or refuse any medical treatment, and access all your medical records without a separate HIPAA release.

Pick someone who can make difficult decisions under pressure, not just someone you trust emotionally. Name at least one alternate agent in case your primary can't serve.

2. Document Your Treatment Preferences (Living Will)

The Living Will states what decisions you want made — the specific conditions under which you want life-sustaining treatment continued, reduced, or withdrawn. Go beyond the checkbox format of the blank state form:

• Define what "excessively burdensome treatment" means to you personally
• Address medically administered nutrition and hydration separately (your Living Will can refuse this; it legally cannot refuse food and water offered for normal consumption)
• Consider adding a Dartmouth Dementia Directive if progressive cognitive decline is a concern — the standard Living Will only triggers on terminal condition or permanent unconsciousness, not the middle stages of dementia

3. Execute the Document Correctly

This is where most self-completed directives fail. RSA 137-J:14 requires either:

• Two qualified witnesses — and both must be free of all nine disqualification categories: not your agent, not your spouse, not your heirs or beneficiaries, not your attending physician, and (if you're signing in a healthcare facility) no more than one facility employee
• One notary public — which replaces both witnesses and eliminates the most common execution failure point

Sign the document in the presence of your chosen witnesses or notary. Do not sign first and have witnesses sign later — they must observe your signature.

4. Brief Your Agent

Naming someone on paper is step one. Preparing them is step two. Have a structured conversation covering:

• Your core values about quality of life vs. length of life
• Specific treatment scenarios: ventilator, dialysis, tube feeding, CPR
• The boundary between "do everything" and "let me go"
• Their authority to convert your directive preferences into physician-signed POLST and DNR orders

5. Distribute and Upload

• Original stays at home in an accessible location (never in a safe deposit box — your agent can't access it when they need it)
• Copies to your named agent, your primary care physician, and any hospital network where you receive care
• Electronic upload to Dartmouth Hitchcock, Southern NH Health, or MaineHealth EMR portals if those are your clinical networks

The Three Documents the Free Form Misses

The Foundation for Healthy Communities publishes the official New Hampshire advance directive PDF for free. It covers the DPOAH and Living Will. It does not include:

1. Dartmouth Dementia Directive — stage-specific treatment preferences for early, middle, and late cognitive decline. Without this, your standard directive won't activate during the years-long middle stages of dementia where you most need documented preferences.

2. POLST/DNR medical orders — your advance directive alone will not stop emergency responders from performing CPR. The bright pink Portable DNR form and bright yellow POLST form are physician-signed medical orders that translate your preferences into actionable clinical instructions.

3. Agent briefing protocol — the structured conversation framework that ensures your agent can actually implement your wishes under crisis conditions, navigate hospital legal departments, and coordinate with the clinical team.

The New Hampshire Advance Directive & Living Will Kit includes all three supplemental components alongside the core DPOAH and Living Will, with a pre-signing verification checklist that catches witness eligibility errors before they become problems.

Common Mistakes That Invalidate the Document

• Wrong witnesses: having your spouse, your named agent, or an heir witness your signature — all are disqualified under RSA 137-J:14
• Pre-2021 templates: national platforms like Rocket Lawyer and pdfFiller still use templates that predate the SB 74 update, missing the broadened default authority provisions
• No POLST coordination: assuming your Living Will alone will govern emergency care — it won't if paramedics respond to a 911 call
• Safe deposit box storage: placing the original where your agent can't access it during a weekend emergency

Frequently Asked Questions

Is a self-completed advance directive as legally valid as one from an attorney?

Yes. RSA 137-J makes no distinction based on who drafted the document. The same execution requirements apply regardless. Hospital legal departments review all directives against the same statutory criteria.

Do I need a notary or can I use witnesses?

Either works. Two qualified witnesses or one notary public satisfies RSA 137-J:14. The notary option is simpler because it eliminates the risk of inadvertently using a disqualified witness — a single notary at any UPS Store or bank replaces two witnesses.

What if I have property in another state?

Complete a New Hampshire-specific directive for your primary residence and healthcare networks. If you spend winters in Florida, Arizona, or South Carolina, consider having your directive reviewed for recognition in that state — New Hampshire generally has reciprocity, but specific POLST/DNR forms are state-specific.

Can I revoke the directive later?

Yes, through any of three methods under RSA 137-J: a signed written revocation, an oral revocation made to two witnesses, or by executing a new directive (which automatically revokes the old one). The Five Ds framework — Death, Divorce, Diagnosis, Decline, Decade — is a practical reminder for when to review and potentially update.

How long does it take to complete?

With a comprehensive kit that walks you through each decision and the execution protocol, most people complete the process in one sitting — typically two to three hours including the agent briefing conversation. Without guidance, the research and decision-making process can stretch over weeks.

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