How to Make an Advance Health Directive in QLD

Before You Start: What You'll Need

Completing a Queensland Advance Health Directive (Form 4) isn't a single sitting — it involves coordination between you, your registered medical practitioner, an eligible witness, and any attorneys you appoint. Knowing the full process upfront prevents the most common delays.

You'll need:

• A downloaded copy of Form 4 (Version 5) from the Queensland Publications Portal
• A registered medical practitioner appointment specifically for completing Section 5 (the capacity certificate) — a standard 15-minute consult is usually too short
• An eligible witness: a Justice of the Peace, Commissioner for Declarations, lawyer, or notary public
• Photo identification for the witnessing session
• Names and contact details of anyone you plan to appoint as a health attorney

Allow time for the registered medical practitioner appointment and JP availability; the completion time will depend on those arrangements.

Step 1: Book a Longer Registered Medical Practitioner Appointment

Your registered medical practitioner needs to do two things: discuss the clinical implications of the treatment decisions you're recording, and complete the Section 5 capacity certificate confirming you have the cognitive ability to make those decisions.

This isn't a tick-box exercise. A thorough GP consultation covers:

• The mechanical reality of CPR, including rib fractures, potential brain damage, and survival rates (which drop significantly outside hospital settings)
• What mechanical ventilation involves and its side effects
• Artificial nutrition via nasogastric tube or PEG tube — what daily life looks like
• The four statutory trigger conditions under which life-sustaining treatment refusals take effect in Queensland

Ask your registered medical practitioner to explain each treatment option so you can make informed decisions about what to accept and what to refuse. Request a longer appointment — 30 to 45 minutes — and let the practice know in advance that you're completing an AHD.

Your registered medical practitioner signs and dates Section 5 at the end of this consultation. This signature must come before the witnessing step.

Step 2: Complete the Treatment Directions

With the clinical consultation behind you, fill out the treatment sections of Form 4. This is where specificity matters.

Use precise clinical language. "No heroic measures" means nothing legally. Instead, state exactly which treatments you refuse and under which statutory conditions. For example: "I refuse cardiopulmonary resuscitation if I have an incurable or irreversible terminal illness or condition and, in the opinion of my treating doctor and another doctor, may reasonably be expected to die within one year."

Cover the four statutory triggers. Queensland law only permits a direction to withhold or withdraw life-sustaining treatment to operate when one of these applies: a terminal illness with no reasonable prospect of recovery where the treating doctor and another doctor agree that death is expected within one year; a persistent vegetative state with no reasonable prospect of cognitive recovery; a permanent coma with no reasonable prospect of regaining consciousness; or an illness or injury of such severity that the person will permanently require life-sustaining treatment to survive. Your directions should reference which conditions apply to each treatment decision.

Don't forget palliative care. A refusal of life-sustaining treatment does not restrict pain relief or comfort care. You can refuse ventilation while still consenting to full palliative care — and you should explicitly state this to avoid any ambiguity.

Mental health directions. You can include or exclude psychiatric treatments like electroconvulsive therapy (ECT). If mental health decisions are important to you, consider using Queensland Health's specific AHD for Mental Health form alongside the standard Form 4.

Step 3: Sign Before an Eligible Witness

This must happen as soon as practically possible after your registered medical practitioner completes Section 5. The timing matters because capacity can fluctuate — especially for people with progressive conditions. A gap of weeks between the capacity assessment and the witnessing session creates a vulnerability.

Bring the completed form (with Section 5 signed) and your photo ID to the witnessing session. The witness will:

1. Ask you open-ended questions to independently verify your capacity
2. Confirm you understand the nature and effect of the document
3. Complete the witness certificate, including the total page count
4. Sign the form

Print the document single-sided on white A4 paper. Sign in blue or black ink. Both requirements sound trivial, but they're specified in the form guidance and non-compliance can trigger rejection.

Step 4: Attorney Acceptance

If your AHD appoints an attorney for health decisions, they need to read the explanatory information and sign the acceptance section (Section 8). Until they do, the appointment isn't active — they can't make any decisions on your behalf.

Your attorney doesn't need to be present during your witnessing session. They can sign their acceptance section separately. But don't delay this step — an unsigned acceptance means no appointed decision-maker, which defaults to the Statutory Health Attorney hierarchy if you lose capacity before the acceptance is completed.

Step 5: Distribute and Register

A completed AHD sitting in a drawer is legally valid but practically useless. Distribute copies to:

• All appointed attorneys and substitute attorneys — they need a copy to present to institutions
• Your GP and any specialist doctors — so it's on your medical file
• Your local hospital's admissions office — especially if you have a condition requiring regular hospital visits
• The Statewide Office of Advance Care Planning — submit via email ([email protected]), fax (1300 008 227), or post (PO Box 2274, Runcorn QLD 4113). This uploads your AHD to Queensland Health's electronic record system, "The Viewer," where paramedics and hospital clinicians can access it state-wide during emergencies

Keep the original in a secure, fireproof location. The Queensland Public Trustee offers free safe custody for original planning documents.

Consider carrying a wallet card noting that you have an AHD, listing your attorneys' names and contact numbers, and specifying where the original is stored.

Navigate Every Section of Form 4 With Confidence

The line between a valid AHD and an invalidated one often comes down to technical execution — signing sequence, witness eligibility, and clinical phrasing. Our Queensland Advance Directive & Living Will Kit provides a section-by-section walkthrough of Form 4 with GP consultation worksheets, clinically tested treatment direction templates, and a distribution checklist.

See more Queensland guides →