New Jersey Advance Directive Form (Medical POA + Living Will)

A New Jersey advance directive is a set of instructions that contains either directives for a patient’s future medical wishes, assignment of a health care proxy, or both. The instruction directive allows the patient to list specific care they would or would not like physicians to deliver, and the health care proxy is assigned by the Principal to act in their stead for applicable medical decisions when the Principal falls into a state of incapacitation.

Spanish (Español) VersionAdobe PDF

What’s Included?

Laws

Signing Requirements (NJ Rev Stat § 26:2H-56) – Two (2) Adult Witnesses

State Definitions

  • Advance Directive for Health Care (NJ Rev Stat § 26:2H-55) – “Advance directive for health care” or “advance directive” means a writing executed in accordance with the requirements of P.L.1991, c.201. An “advance directive” may include a proxy directive or an instruction directive, or both.
  • Declarant (NJ Rev Stat § 26:2H-55) – “Declarant” means an adult who has the mental capacity to execute an advance directive and does so.
  • Instruction Directive (NJ Rev Stat § 26:2H-55) – “Instruction directive” means a writing which provides instructions and direction regarding the declarant’s wishes for health care in the event that the declarant subsequently lacks decision making capacity.
  • Proxy Directive (NJ Rev Stat § 26:2H-55) – “Proxy directive” means a writing which designates a health care representative in the event the declarant subsequently lacks decision making capacity.

Versions (5)


blankAARP

Download: Adobe PDF

 

 

 

 


blankHackensack Medical Center

Download: Adobe PDF

 

 

 

 


blankNew Jersey.gov

Download: Adobe PDF

 

 

 

 


blankVirtua Health

Download: Adobe PDF

 

 

 

 


blankNew Jersey Catholic Conference

Download: Adobe PDF