Maryland Advance Directive Form: Where to Get It and How to Fill It Out

Where to Get the Official Form

The Maryland Office of the Attorney General publishes the statutory advance directive form as a free PDF download through the state health department. You can also request printed copies from your county Register of Wills or your primary care physician's office. MedStar Health, Frederick Health, and Adventist HealthCare all distribute the form during patient intake.

The form is available in English and Spanish. The Montgomery County Palliative Care and End of Life Coalition provides translated versions in additional languages through local health coalitions.

Every version follows the same statutory framework established by the Health Care Decisions Act (Md. Code, Health-General § 5-601 through § 5-618). There is no special "2026 edition" — the current form has been valid since the Act's last amendment and remains current.

What the Form Contains

The statutory form has three parts:

Part I: Selection of Healthcare Agent. You name one primary agent and optionally one or two backup agents. You choose whether the agent's authority activates only when you lose capacity (the default) or immediately upon signing.

Part II: Treatment Preferences (Living Will). You specify your wishes regarding life-sustaining treatments — mechanical ventilation, CPR, and artificial nutrition and hydration — for three clinical states: terminal condition, persistent vegetative state, and end-stage condition.

Part III: Signature and Witnesses. You sign, date, and have two adult witnesses sign. This is where most self-prepared forms fail.

The Initials Requirement Most People Miss

Maryland is one of the states that requires physical initials rather than checkmarks to indicate your treatment preferences. In Part II, you must write your initials next to the specific statement that reflects your choice. Using a checkmark, an X, or any other mark is legally insufficient and can lead to the invalidation of your treatment preferences during a clinical dispute.

This means if you are filling out a printed PDF, do not check boxes — write your initials clearly next to each selected option.

Filling It Out Step by Step

Step 1: Agent selection. Write the full legal name, address, and phone number of your primary healthcare agent. If you want backups, fill in their information in the designated spaces. Decide whether you want immediate authority or incapacity-triggered authority.

Step 2: Treatment preferences. Read each clinical scenario carefully. For each one, initial next to the statement that matches your wishes. You have three choices per scenario: receive all treatments, withhold treatments, or a middle ground (trial period then withdraw if no improvement).

Step 3: Additional instructions. Use the open space to write any specific preferences the form does not cover — religious considerations, pain management priorities, or organ donation wishes.

Step 4: Execution. Sign and date the document in front of two adult witnesses. Your healthcare agent cannot be a witness. At least one witness must be someone who will not inherit from you or administer your estate.

Common Mistakes That Invalidate the Form

Using the wrong witnesses. Naming your healthcare agent as a witness, or having both witnesses be people who inherit from your estate, violates the statutory requirements.

Checkmarks instead of initials. The form explicitly requires initials. Checkmarks or X marks can render your treatment preferences unenforceable.

Failing to sign all three parts. Each section of the form requires your signature or initials where indicated. Skipping a section leaves it legally void.

Filing with the court. Maryland advance directives should not be filed with the Attorney General or the courts. Instead, distribute copies to your healthcare agent, your primary physician, and upload to MyDirectives.com — the state's designated digital repository.

Why the Free Form Alone May Not Be Enough

The statutory form covers the basics. It does not address progressive cognitive decline from Alzheimer's or dementia, where the standard three clinical scenarios fail to capture the slow, staged nature of capacity loss. It does not guide you through the MOLST process that EMS actually follows in emergencies. And it does not explain how your healthcare decisions interact with Maryland's dual estate and inheritance tax system.

The Maryland Advance Directive & Living Will Kit includes the complete statutory form plus annotated instructions, a dementia progression supplement, the MOLST preparation worksheet, and the probate-avoidance tools that the free form leaves out entirely.

See more Maryland guides →