Oregon Advance Directive Form

Oregon's advance directive does two things: it appoints a Health Care Representative to make medical decisions if you lose capacity, and it records your treatment preferences for end-of-life care. The form is free from the Oregon Health Authority, but the execution rules under ORS 127.531 are strict enough that a single witness error can invalidate the entire document.

The Witness Requirements That Trip People Up

An Oregon advance directive must be either notarized or signed by two qualified adult witnesses. Most families choose witnesses — but the disqualification rules are specific:

• Neither witness can be the appointed Health Care Representative or any alternate representative
• Neither can be the principal's attending physician or health care provider
• Neither can be an employee of the principal's care facility or attending provider
• At least one witness must be unrelated to the principal by blood, marriage, or adoption, and must have no claim on the principal's estate

That last requirement catches many families off guard. If both witnesses are family members, the directive is invalid.

Care facility rule: If the principal signs while a patient or resident in a long-term care facility, one witness must be either a qualified facility witness or a representative of the Oregon Long-Term Care Ombudsman.

Advance Directive vs. POLST — They Are Not the Same

A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order signed by a clinician. It gives emergency responders immediate instructions about CPR, intubation, and tube feeding. A POLST can be updated or voided at any time by the patient and their doctor.

An advance directive is a legal planning document signed by the patient. It appoints a decision-maker and records broader treatment preferences.

The practical difference: paramedics follow a POLST. Hospital ethics committees and health care representatives follow the advance directive. Most families managing a progressive decline need both documents, because the POLST handles emergency scenarios while the advance directive governs longer-term care and placement decisions.

What the Health Care Representative Can and Cannot Do

The appointed representative has authority over medical decisions, including consenting to or refusing treatment, choosing between care facilities, and making placement decisions between assisted living, residential care, and nursing home settings. This authority applies if the principal becomes mentally incapacitated and cannot make their own medical decisions.

The representative does not have financial authority. They cannot access bank accounts, sign contracts, or manage property. That requires a separate Durable Power of Attorney.

When You Cannot Create an Advance Directive

If your parent has already lost cognitive capacity, they cannot sign an advance directive. The family must then petition for guardianship under ORS Chapter 125 — a court process that requires a filing fee ($124), a court visitor investigation ($300–$400), and attorney fees typically running $4,500–$6,500 for uncontested cases.

This is why elder law attorneys universally recommend completing both the advance directive and the durable POA well before any cognitive decline becomes apparent.

Connecting Legal Authority to Care Decisions

The advance directive is one piece of a larger care planning process. Understanding Oregon's CAPS assessment, Medicaid eligibility thresholds, and the differences between care settings like adult foster homes, assisted living, and nursing facilities helps the appointed representative make informed placement decisions when the time comes. Our Oregon care decision guide covers the full sequence from legal authority through facility vetting and financial qualification.

See more Oregon guides →