Advance Healthcare Directives

Forms

Updated Refund Policy

Refund requests must be made within 45 consecutive days of receipt of funds and will only be issued for amounts over $10.00.

Notice

Gov. Stein signed House Bill 388 into law on June 30, 2025, extending Emergency Video Notarization. The new law extends the Emergency Video Notarization sunset to 12:01 a.m. on July 1, 2026, or the date the Secretary issues the first license under the Remote Electronic Notarization Act, whichever comes first.

Advance Health Care Brochure (PDF)
Registration Form (PDF)

Registration Form (Word)
Removal Form (PDF)

Removal Form (Word)
Health Care Power of Attorney (PDF)

Health Care Power of Attorney (Word)
Advance Directive for a Natural Death ("Living Will")(PDF)

Advance Directive for a Natural Death ("Living Will") (Word)
Advance Directive for Mental Health Treatment (PDF)

Advance Directive for Mental Health Treatment (Word)
Organ/Tissue Donor Card (PDF)

Organ/Tissue Donor Card (Word)

Fees

The fee for each Advance Health Care Directive to be registered is $10.00. After the documents are filed, a Registry Card containing a unique file number and password will be issued to the applicant. The applicant can use the file number and password to access the directive(s) online 24 hours a day, 7 days a week, 365 days per year.

If paying by check, make checks payable to: "North Carolina Secretary of State"