How to Fill Out Advance Medical Directive Quebec

Getting the Right Form

The DMA form isn't a generic template you download from anywhere. It's a personalized, barcoded document tied to your RAMQ file, and there's only one legitimate way to get it.

Online: Log into your ClicSÉQUR account on the RAMQ website. Navigate to the advance medical directives section. The system generates a form with your personal information and a unique barcode already embedded.

By phone: Call RAMQ directly and request a copy. They'll mail a barcoded form to your address on file.

You cannot use a photocopy of someone else's form, a generic template from a law office, or a downloaded PDF from a third-party website. RAMQ rejects submissions without a valid barcode — this is one of the most common reasons registrations fail.

Filling Out the Form Section by Section

The DMA form includes information sheets and decision sections. Do not skip or detach any pages — RAMQ requires the complete document, information sheets included.

The decision grid asks you to accept or refuse five treatments under three clinical conditions:

For each cell, you mark one choice. You don't have to refuse everything — many people refuse CPR and mechanical ventilation in a terminal state but accept artificial hydration during severe cognitive decline. The form accommodates any combination.

If you're uncertain about a particular treatment-scenario combination, speak with your family physician before completing the form. They can explain what each intervention involves clinically and help you think through the practical implications of accepting or refusing it.

Signing With Witnesses

The signing requirements are strict, and getting them wrong invalidates the entire document:

You must sign in the physical presence of two adult witnesses. All three of you — the person making the directives and both witnesses — must be present together at the same time, watching each other sign and date the document.

Witness disqualifications. Neither witness can be:

• Named as your mandatary in a protection mandate
• Named as your substitute mandatary
• Designated to receive your rendering of accounts
• A member of your direct healthcare team

If you're physically unable to sign, you can designate another competent adult to sign on your behalf. This person cannot be part of your healthcare team. They must sign in your physical presence, under your explicit instruction, with both witnesses observing.

Date everything. The date on your signature and both witnesses' signatures must match — all signed on the same day, in the same sitting.

Submitting to RAMQ

Mail the complete, signed original — all pages, including the information sheets — to the RAMQ address provided on the form. Keep a copy for your records before mailing.

Processing time: 10 to 15 business days from when RAMQ receives the physical mail. You'll receive a confirmation letter once your directives are registered in their central database.

What happens during the gap: Until RAMQ processes your registration, hospital systems won't show your directives electronically. To bridge this period, give signed copies to your family doctor and your local CLSC and ask them to add it to your medical chart. Keep a copy at home in a place your family knows about.

Where Else to Store Copies

Registration with RAMQ is the primary step — it puts your directives in the provincial electronic system that emergency departments and hospitals can access. But redundancy protects you:

• Family doctor and CLSC: Deliver a physical copy and ask them to scan it into your permanent medical file
• Your mandatary: If you have a protection mandate, your named representative should know your directives exist and have a copy
• Home filing: Keep the RAMQ confirmation letter and a copy of the signed form together with your protection mandate and other legal documents
• Emergency wallet card: A card noting "I have registered Advance Medical Directives with RAMQ" with your mandatary's name and phone number

If You Made a DMA Through a Notary

You can also have your DMA drafted as a notarized act. This costs between $150 and $250 through a notary's office, and the notary handles the RAMQ registration for you. The notarized version has the same legal effect as the self-completed RAMQ form — neither carries more weight than the other.

The notarial route makes sense if you're already meeting with a notary for a protection mandate or will and want everything handled in one appointment. Otherwise, the free ClicSÉQUR form achieves exactly the same result.

After Registration: What to Verify

Once you receive the RAMQ confirmation letter:

• Confirm that all five treatment decisions are recorded correctly
• Ask your family doctor to verify they can access your directives through the provincial system
• Inform your mandatary and close family members that you've registered

For the full advance care planning workflow — including the protection mandate builder, DMA treatment worksheet, and a document storage plan — the Quebec Advance Directive Kit provides fillable tools specific to Quebec's civil law system.

See more Quebec guides →