Tennessee Advance Directive for Health Care: How to Sign It Correctly

A Tennessee advance directive for health care is valid when it is in writing, signed by you, and either notarized or witnessed by two qualified adults. That is the core rule in Tenn. Code Ann. § 68-11-1803(b), and it is the part families most often get wrong, usually by asking the wrong people to witness. This guide explains what the document does, where to get the state form, how to choose between witnesses and a notary, and what to do with copies once it is signed. It explains the law; it is not legal advice.

What a Tennessee advance directive for health care does

The directive does two jobs in one document. First, it lets you name an agent (and usually an alternate) to make health care decisions if you cannot. Second, it lets you record instructions about the treatment you would or would not want, such as life-prolonging measures. Under the statute:

• Unless the document says otherwise, the agent’s authority starts only once it is determined that you lack capacity, and stops if you recover it.
• That determination is made by your designated physician.
• The agent must follow your instructions and known wishes, and otherwise decide based on your best interest, considering your personal values.
• The directive stays in effect even after you lose capacity, which is the point of signing it while you are well.

This differs from a financial power of attorney, which covers money and property. If you are sorting out which document does what, our explainer on durable versus medical power of attorney lays out the differences, and the power of attorney notary service page covers how those documents are signed.

Where to get the Tennessee advance directive form

The Tennessee Department of Health publishes a two-page Advance Directive for Health Care form. It combines the older “living will” and “appointment of health care agent” ideas into one document: you name an agent and alternate, indicate your wishes about quality of life and specific treatments, and add any other instructions. The state’s advance directive FAQ says you can complete it without a lawyer.

You are not required to use the state form. A directive drafted by an attorney, or a form from a hospital or advance care planning program, works as long as it meets the signing rules. Older Tennessee living wills and durable powers of attorney for health care signed under earlier laws are still given effect under the statutes they were made under.

Witnesses or a notary: the signing rule

Tennessee gives you two ways to make the directive valid. Pick one.

	Option A: two witnesses	Option B: notary public
Who must be present	You and two competent adult witnesses	You and a commissioned notary
Restrictions	Neither witness can be your agent; at least one must be unrelated to you and not an heir	The notary checks your identity and your willingness to sign
What gets completed	Witness signatures plus the attestation clause confirming they qualify	The notary’s certificate and seal
Good fit when	Two suitable adults are easy to gather	Family members are the only people around, or finding an unrelated witness is hard

Tennessee advance directive witness requirements

Under § 68-11-1803(b), each witness must be:

• A competent adult.
• Someone other than the person you name as your agent.

And at least one of the two must also be someone who:

• Is not related to you by blood, marriage or adoption, and
• Would not inherit any part of your estate under a will or by law.

So your adult daughter can be one witness if she is not your agent, but the second witness has to be an unrelated person who is not in your will. The written directive must also include an attestation clause in which the witnesses confirm they meet these rules; the state form includes one. For a broader look at when documents need witnesses as well as a notary, see do you need witnesses in addition to a notary.

Hospitals and care facilities often have their own policies about whether staff may act as witnesses, so do not count on borrowing a nurse. This is one of the main reasons families choose the notary option.

How to sign it correctly, step by step

1. Fill in everything except the signature. Names, phone numbers, your treatment choices and any added instructions should be complete beforehand.
2. Talk to your agent first. Make sure the person you name is willing to serve and understands your wishes.
3. Decide: witnesses or notary. If using witnesses, confirm that at least one qualifies as unrelated and not an heir.
4. Have ID ready if a notary is involved. Tennessee’s rules on acceptable ID for notarization apply at the bedside just as they do at an office.
5. Sign in the presence of the witnesses or the notary, then have them complete their part on the same page.
6. Make copies right away and distribute them (see below).

When the person signing is in the hospital, the practical questions change: is the patient alert, can they hold a pen, when are visiting hours? Our hospital and bedside notary guide covers those. If there are concerns about memory or understanding, read whether a notary can notarize for someone with dementia before booking; a notary will decline if the signer does not appear to understand the document. The general process for any notarized signing is in our guide on how to get a document notarized.

After signing: copies and where to keep them

A directive locked in a safe deposit box does not help anyone in an emergency room. Tennessee’s FAQ suggests giving a copy each to your agent, your alternate agent, your doctor and your local hospital. Tennessee law also gives a copy the same effect as the original, so copies are genuinely useful. Keep the original where your agent knows to find it, and note on your calendar to review it every few years or after a major life change.

Financial powers of attorney end differently; our guide to revoking a power of attorney in Tennessee explains written notice, notarization and recording with the register of deeds.

Changing or revoking your advance directive

Under Tenn. Code Ann. § 68-11-1804, a person with capacity can:

• Revoke the choice of agent only by a signed writing or by personally telling the supervising health care provider.
• Revoke all or part of the rest of the directive at any time, in any way that communicates the intent to revoke.

A divorce, annulment or legal separation revokes the designation of a spouse as agent unless the decree or directive says otherwise, and a newer directive overrides an older one wherever the two conflict. When you update, collect the old copies you handed out and replace them.

Frequently Asked Questions

Does a Tennessee advance directive need to be notarized?

No. Tennessee law requires the advance directive to be either notarized or signed in front of two qualified witnesses. You can choose either route; you do not need both.

Can my health care agent be one of the witnesses?

No. A witness cannot be the agent named in the directive. In addition, at least one of the two witnesses must be unrelated to you by blood, marriage or adoption and must not stand to inherit from you.

Do I need a lawyer to complete the state form?

The state’s own guidance says an Advance Directive for Health Care can be completed without a lawyer. If your situation is complicated, for example a blended family or disagreement about who should decide, talking with an elder law attorney is still wise.

Is a photocopy of my advance directive valid?

Tennessee law gives a copy of a written advance directive the same effect as the original, which is why it makes sense to hand copies to your agent, your doctor and your hospital.

Will Tennessee honor an advance directive signed in another state?

Generally yes. A directive signed outside Tennessee by someone who was not a Tennessee resident at the time is given effect if it complies with Tennessee’s law or the law of the state where the person lived.

Signing an advance directive in Hixson or Chattanooga

If you would rather use the notary option, Priority Mobile Notary Services can come to a home, hospital room or assisted living facility around Hixson and Chattanooga to notarize an advance directive. Karen McCormick is a Tennessee notary, not an attorney, so she can verify identity and notarize the signature but cannot help choose treatment options or explain what the form means for your situation. Call (423) 401-8316 or use the contact form to ask about availability; same-day visits may be possible.