Maryland Advance Directive Registry: Where to Store and How to Access Your Documents

Where Your Advance Directive Should Live

Completing a Maryland advance directive is only half the job. If no one can find it during a medical crisis, it might as well not exist. Maryland does not require you to file your advance directive with any court or government office — in fact, you should not file it with the Attorney General or the courts.

Instead, effective distribution means placing copies where the people who need them can access them immediately.

The Five-Copy Distribution Protocol

Copy 1: Your healthcare agent. Your primary agent needs a physical or digital copy they can produce at a hospital within minutes. If you have named backup agents, give them copies too.

Copy 2: Your primary care physician. Your doctor's office uploads the document to your Electronic Health Record (EHR), making it accessible to any provider within that health system.

Copy 3: Your hospital. If you have a hospital where you would most likely be admitted — whether it is MedStar, Johns Hopkins, Frederick Health, or a community hospital — provide a copy during your next visit or admission. Hospital intake teams are federally required to ask about advance directives upon admission.

Copy 4: MyDirectives.com. This is Maryland's designated free online repository for advance directive documents. Uploading your directive here allows emergency clinicians at connected facilities to verify your healthcare preferences electronically, even if no physical copy is immediately available.

Copy 5: A secure home location. Keep the original in a place that is accessible in an emergency — a kitchen drawer, a bedside table, or a designated home medical file. A safe deposit box that requires a bank visit to open defeats the purpose.

The Medical Wallet Card

Maryland supports the use of a medical wallet card — a small card you carry in your wallet or purse that alerts emergency responders to the existence of your advance directive and tells them where to find it.

The card typically includes:

• Your name and date of birth
• Your healthcare agent's name and phone number
• Where your documents are stored (physician's office, MyDirectives.com)
• Whether you have a MOLST or EMS/DNR order

In an emergency, this card can be the difference between EMS following your wishes and EMS defaulting to full resuscitative measures because they cannot verify your preferences.

What the Attorney General's Form Does Not Tell You

The state's official advance directive form instructs you to give copies to your healthcare agent and physician. It does not mention MyDirectives.com, the medical wallet card, or the practical reality that hospital staff rotate constantly and your admission file from last year may not surface during a late-night emergency.

Effective storage is active distribution, not passive filing. Your advance directive should be findable by at least three independent paths: through your agent (who may be at home), through the hospital's records system, and through an online repository that clinicians can query electronically.

Updating and Re-Distributing

Whenever you update your advance directive — changing your healthcare agent, modifying treatment preferences, or adding a dementia supplement — you need to redistribute the new version to every location that holds the old one. Notify your physician's office, update MyDirectives.com, replace copies held by your agent, and destroy outdated versions to prevent confusion.

The Maryland Advance Directive & Living Will Kit includes a printable medical wallet card template and a distribution checklist that tracks every copy you have placed, so updating is a matter of following the list rather than trying to remember who received what.

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