To be on a particular form,

To be notarized,

To be written by an attorney, or

To have physician documentation as to capacity.

The signature of the person making it, and

The signatures of two adults who witness the person signing the AD.

Va. Code § 54.1-2983.2

For an AD to be valid, its maker must have had capacity to make informed decisions about their care.

Importantly, Virginia law presumes that
“every adult…is capable of making an informed decision. …No person shall be deemed incapable of making an informed decision based solely on a particular clinical diagnosis.”


  • A current judicial finding of incapacity (e.g., guardian for health care decisions),
  • A current clinical finding of incapacity by two physicians (or by a physician and a licensed clinical psychologist)

An AD does not need:

Document requirements
Va. Code § 54.1-2983

An AD needs only:

Photocopies (faxes, EMR copies) of the original are valid for use by health care providers.

Virginia Requirements for Making a Legally Binding AD