Massachusetts Advance Directive Form (Medical POA + Living Will)

A Massachusetts advance directive is a document that allows a principal to list their intended medical wishes and assign a representative, called a healthcare proxy, to guide medical providers when the principal reaches a state of incapacitation. Massachusetts is one of few states that does not recognize living wills as having legal authority, but the document, which is sometimes called a “personal wishes statement,” may still be included in an advance directive for medical providers to reference.

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What’s Included?


Signing Requirements (§ 201D-2) – Two (2) witnesses

State Definitions

  • Health Care Agent (§ 201D-1) – ”Health care agent” or ”agent”, an adult to whom authority to make health care decisions is delegated under a health care proxy.
  • Health Care Proxy (§ 201D-1) – ”Health care proxy”, a document delegating to an agent the authority to make health care decisions, executed in accordance with the requirements of this chapter.

Versions (4)


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University of Massachusetts

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Brigham and Women’s Hospital

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blankArchdiocese of Boston

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