Ohio Advance Directive Form (Medical POA + Living Will)

An Ohio advance directive is a document that allows a patient (called the principal) to list out medical directives to be invoked by providers at a later date if the patient were to fall into a state of incapacitation. The principal may name an agent (health care power of attorney) to make medical choices on their behalf. Agents may only assume decision-making authority when the patient cannot communicate.

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Signing Requirements (§ 2133.02(A)(1)) – Two (2) witnesses or a notary public.

State Definitions

  • Declaration (§ 2133.01(f)) – “Declaration” means a written document executed in accordance with section 2133.02 of the Revised Code.
  • Durable Power of Attorney for Health Care (§ 2133.01(g)) – “Durable power of attorney for health care” means a document created pursuant to sections 1337.11 to 1337.17 of the Revised Code.

Versions (4)


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Ohio Hospital Association

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Cleveland Clinic

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blankMercy Health

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