Only about 30% of California adults have completed an Advance Healthcare Directive. If you’re in the other 70%, your family will face one of life’s hardest decisions without your guidance. Here’s what every San Diego family needs to know about getting this document in place.
An Advance Healthcare Directive (AHCD) is a legal document that lets you make two critical decisions before a medical crisis forces someone else to make them for you:
1. Who speaks for you — you appoint a healthcare agent, the single person empowered to make medical decisions when you cannot.
2. What you want — you document your preferences for life-sustaining treatment, resuscitation, organ donation, and other medical choices.
Without an AHCD, California law applies a hierarchy of decision-makers —spouse first, then adult children, then parents, then siblings. That may not reflect who you actually trust. And it tells your medical team nothing about what you actually want.
The AHCD is especially important in California because state law has specific witnessing and notarization requirements that vary from most other states. Getting it right matters.
California’s official AHCD form covers three main areas. For a broader look at what legal documents your family needs, see our San Diego estate planning checklist and the guide on writing a will in California.
You name the person who will make medical decisions on your behalf if you’re incapacitated. You can name an alternate agent if your primary choice is unavailable. Your agent cannot be your healthcare provider or an employee of your healthcare provider.
This is the most consequential decision in the document. Choose someone who lives nearby, can remain calm under pressure, and understands your values — not just your preferences.
You document your wishes for medical treatment if you can’t communicate. This covers:
California’s form also lets you specify funeral and disposition wishes, privacy preferences for your medical records, and any other instructions you want documented. This is where you can record wishes that go beyond pure medical care.
Digital copy tip: Keep a digital copy in a secure, accessible location. The physical document matters in an emergency — but your family also needs to be able to find it. A secure digital vault solves this problem. Use our checklist to track your documents and ensure your family knows where everything is.
California has two documents that sound similar and serve very different purposes. Understanding the difference prevents confusion at a critical moment.
| Advance Healthcare Directive (AHCD) | POLST Form | |
|---|---|---|
| Who completes it | You (the individual), independently or with help | Healthcare provider, based on your health status and wishes |
| Legal nature | Legal document — directive to your agent and providers | Physician medical order — actionable by EMS and hospital staff |
| Who needs it | Every California adult, age 18+ | People with serious illness, advanced age, or specific end-of-life conditions |
| Emergency use | Paramedics look for it but may not be bound to follow it | Paramedics and ER staff are legally required to follow it |
| California form color | Standard white form | Bright pink (California requirement) |
Most adults need both: an AHCD for general planning and appointing an agent, plus a POLST if they develop a serious or life-limiting illness. Your primary care physician can advise on whether a POLST is appropriate for your situation.
Key point: An AHCD is your planning document — it applies broadly across your life. A POLST is a medical order for a specific health situation. Think of the AHCD as your foundation and the POLST as a layer that may be added later based on your health circumstances.
California’s AHCD requirements are specific. Following them ensures your document is legally valid when it matters.
The California Attorney General’s Office provides the official form at oag.ca.gov at no cost. You can also get it through your primary care physician, most hospital social work departments, or the San Diego County Aging & Independence Services office.
You must be of sound mind when signing — meaning you understand what the document is, what it does, and the consequences of signing it. This is a legal standard, not a medical one. If there are questions about your capacity at signing time, the document can be challenged. If you have concerns, consult an elder law attorney.
California allows two paths: (A) Two adult witnesses sign, at least one of whom is not related to you and not named in your will, or (B) A notary public notarizes your signature. Your healthcare agent cannot serve as a witness. Family members who are not beneficiaries under your will can serve as witnesses.
Give a copy to your healthcare agent, your primary care physician, and your alternate agent. Keep the original somewhere your family can find it quickly in an emergency. Many families keep the original in a home safe or with their attorney — but make sure your agent knows where.
The document is useless if no one knows where it is or can’t access it in an emergency. SettledWell’s secure vault lets you store your AHCD digitally alongside your other estate documents, with access for your designated family members. Create a free vault to get started.
You can change or revoke your AHCD at any time — it’s not permanent in a way that locks you in. If your wishes change, complete a new form and redistribute it.
Physical storage is important, but digital access is what makes the difference in a real emergency. Here’s what most San Diego families do:
SettledWell Vault: Our secure digital vault stores your AHCD alongside your will, trust, insurance documents, account information, and final wishes — everything your family needs in one place. Add documents any time, designate family access, and rest assured that your affairs are organized and findable. Start with our free checklist to document what you have and what you still need to collect.
Getting help completing your AHCD in San Diego — especially if you need notary access or elder law guidance —:
Free official form at oag.ca.gov. The form includes instructions in English, Spanish, Chinese, Vietnamese, Korean, Tagalog, and Russian.
San Diego County’s Area Agency on Aging offers free AHCD assistance and notary referrals for seniors. Call (800) 510-2020 or visit sandiegocounty.gov/hhsa.
All major San Diego health systems have social workers and patient advocates who can help explain AHCD options and provide the form. Ask at your next appointment or call the patient services desk.
For complex situations — blended families, significant assets, family disputes, cognitive decline concerns — an elder law attorney can advise on AHCD strategy. Referral service: (619) 231-0777.
Most UPS Stores offer notary services ($4–$10 per signature). The San Diego County Library system offers free notary service at several branches by appointment. Your bank may also provide free notary services to account holders.
Interactive checklist: Using our 30-item End-of-Life Planning Checklist helps you track your AHCD alongside every other document and decision your family needs. The Legal Documents section walks through what to have and where to store it — and it saves your progress automatically so you can come back any time.