Oregon Advance Directive: Form Requirements, Witnesses, and POLST

If you're relying on a generic advance directive downloaded from a national website, it may not be valid in Oregon. Oregon is one of only six states that requires an advance directive to be "substantially" in the same form as the state-mandated template — meaning Oregon medical providers can legally reject out-of-state or nonconforming documents.

The Oregon legislature overhauled the statutory Advance Directive form in 2021 through Senate Bill 199. If you or a family member has a directive signed before that revision, it's worth reviewing whether it still meets current standards.

What an Oregon Advance Directive Does

An Oregon Advance Directive is a legal document that allows you to:

1. Appoint a health care representative — someone who can make medical decisions on your behalf if you become unable to communicate those decisions yourself.
2. State your healthcare preferences — across a range of scenarios, including terminal illness, permanent unconsciousness, and advanced progressive illness.
3. Give instructions about specific treatments — including life-sustaining treatment, artificial nutrition and hydration (tube feeding), and comfort care preferences.

Without a valid advance directive, healthcare providers and hospitals default to Oregon's statutory hierarchy of decision-makers (starting with a spouse, then adult children, then parents). If family members disagree, or if the decedent had preferences that weren't documented, this can lead to conflicts and delays in care.

Where to Get the Oregon Advance Directive Form

The official 2021 form is available directly from the Oregon Health Authority (OHA). You can download the PDF from the OHA website, search for "Oregon Advance Directive form OHA" to find the current version.

A few important notes about the form:

• It must be the updated 2021 version to comply with Senate Bill 199
• Oregon does provide translations in multiple languages
• The PDF is fillable but must be printed and physically signed — electronic signatures are not currently accepted for advance directives in Oregon

Witness and Notarization Requirements

For an Oregon Advance Directive to be legally valid, it must be signed by the principal (the person making the directive) and either:

• Notarized by a notary public, OR
• Witnessed by two qualified adults who watch you sign the document

If you choose the witness route, both witnesses must be present at the same time and must sign the document. Oregon law imposes specific disqualifications on who can serve as a witness:

• At least one of the two witnesses cannot be related to you by blood, marriage, or adoption
• Neither witness can be a person who will inherit any portion of your estate (a beneficiary under your will or intestate succession)
• Neither witness can be your healthcare provider or an employee of your healthcare provider at the time of signing

These rules exist to prevent conflicts of interest. If your advance directive is witnessed by someone who doesn't qualify — even unknowingly — the document may be challenged.

The Difference Between an Advance Directive and a POLST

These two documents are frequently confused, but they serve different purposes:

Oregon's POLST form (Portable Orders for Life-Sustaining Treatment) is a medical order, not a legal document. It's signed by a licensed healthcare professional based on conversations with the patient, and it gives emergency responders and medical facilities immediate guidance on interventions like CPR, hospitalization, and intubation. EMS personnel must follow a valid POLST; they do not have to follow an advance directive in an emergency situation.

The POLST is particularly important for people with a serious current illness or significant frailty. An advance directive is for planning ahead, when you're still healthy.

You can and should have both. They work together — the advance directive captures your long-term values and designates a decision-maker; the POLST translates current medical decisions into actionable orders.

Registering Your Oregon Advance Directive

Oregon maintains the Oregon POLST Registry through Oregon POLST, but there is no equivalent mandatory state registry specifically for advance directives. Instead, the recommended steps are:

1. Give a copy to your healthcare representative and make sure they know where the original is
2. Give a copy to your primary care physician to place in your medical file
3. If you're regularly treated at a hospital, request that they add it to your records
4. Consider keeping a copy in an accessible place at home (not locked in a safe deposit box)

If emergency services are called to your home, they need to be able to locate a valid POLST quickly. An advance directive kept in a safe deposit box serves no one in an emergency.

After a Death: Advance Directives and Estate Settlement

When someone dies after having an advance directive in place, the document has served its purpose and there are no ongoing legal obligations tied to it specifically. However, for families settling the estate, verifying that the decedent's healthcare representative acted in accordance with the directive can matter if any family members raise concerns about end-of-life decisions.

If the decedent utilized Oregon's Death with Dignity Act, be aware that a separate clinical process applies — both an attending and consulting physician must confirm the terminal diagnosis and confirm the patient's capacity to make healthcare decisions. The advance directive does not initiate that process; the DWDA has its own procedures.

For families navigating an Oregon estate after a death — whether advance directives, death certificates, or the probate process — the Oregon Estate Settlement Guide provides a plain-English roadmap through every major step.

See more Oregon guides →