Virginia Advance Directive Registry: How to Register and Access Your Documents

Completing your advance directive is only half the job. If paramedics can't find it during a midnight emergency, or the ICU attending doesn't know it exists, the document is functionally useless. Virginia solves this problem with the Advance Care Planning Registry (ACPR) — a free, state-sponsored digital vault that puts your medical wishes within seconds of any treating physician in the Commonwealth.

What the ACPR Is and Who Runs It

The Virginia Advance Care Planning Registry is administered by Virginia Health Information (VHI) in partnership with the U.S. Living Will Registry. It's a secure, HIPAA-compliant electronic database where Virginia residents can upload copies of their advance directives, Durable DNR orders, National POLST forms, and anatomical gift declarations.

The service is entirely free for all Virginia residents. There are no annual fees, no subscription, and no expiration date on stored documents.

How to Upload Your Documents

After executing your advance directive with two adult witnesses, you submit a copy to the registry through VHI's online portal. The registry accepts advance directives, healthcare agent designations, DDNR orders, POLST forms, and organ donation declarations.

Once your documents are uploaded, the system issues a unique 12-digit Personal Identification Number (PIN). This PIN is your access key — and the only way anyone can retrieve your documents from the registry. HIPAA privacy rules prevent public searching by name, Social Security number, or date of birth.

Who Can Access Your Documents and How

Attending physicians and participating emergency networks retrieve uploaded documents through secure integrated health information exchanges, specifically the ConnectVirginia network. When you arrive at a hospital or are treated by EMS, your medical team can pull up your directive instantly — provided they have your PIN.

This means you need to distribute your PIN to several people and locations:

• Your designated healthcare agent
• Your primary care physician's office
• Any specialists you see regularly
• A wallet card you carry with you
• Your emergency contacts

If you're admitted to a hospital for planned surgery, bring a printed copy of your directive and provide your PIN to the admitting staff so they can verify the registry copy matches.

Why a Safety Deposit Box Is the Wrong Storage Location

A bank safety deposit box sounds secure, but it's one of the worst places for an advance directive. Banks close on weekends and holidays. Most family members can't access the box without a court order or death certificate. If you're incapacitated on a Friday night, your directive sits locked in a vault while physicians follow the default statutory surrogate hierarchy — which may not reflect your wishes at all.

Keep the original in a clearly labeled folder at home (some families use the refrigerator — EMS teams are trained to check there for medical orders). Upload a copy to the ACPR. Give additional copies to your agent, your doctor, and at least one trusted family member.

Updating and Revoking Registered Documents

Life changes. A new marriage, a divorce, a falling out with your named agent — any of these may require updating your directive. You can upload a revised document to the ACPR at any time, and the new version supersedes the old one.

One critical detail: if you want to formally revoke a directive that's already registered with the ACPR, the revocation request submitted to the registry must be signed and notarized. Oral revocations and physical destruction of the paper copy are legally valid for revoking the directive itself under Virginia law, but the ACPR requires written, notarized confirmation before removing a document from the digital record.

Making Sure the System Works When It Matters

The Virginia Advance Directive & Living Will Kit includes the complete ACPR registration walkthrough — from formatting your documents for upload to distributing your PIN to the right people. It covers the notarization requirements for registry revocations and shows you how to coordinate your advance directive, DDNR, and POLST registrations in one session. Get the complete toolkit to lock down your medical wishes across every access point.

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