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In New Hampshire, an advance directive combines a Durable Power of Attorney for Health Care and a living will into one statutory document. Download the official form from the state or the Foundation for Healthy Communities, then choose your agent, sign with two witnesses or a notary, and give copies to your agent and your medical providers.
TL;DR:
- The New Hampshire advance directive merges a durable power of attorney for health care and a living will into one legally binding form, with specific signing and witness rules.
- It becomes active only when a medical professional records that the individual lacks decision-making capacity, not immediately upon signing.
- Completing the form properly involves talking with your chosen agent and distributing copies to relevant providers, with electronic upload options available at some hospitals.
- Without an advance directive, medical decisions default to a statutory surrogate order, which may not reflect personal wishes and can result in court proceedings.
- Consulting an attorney is advisable when complex medical wishes or family conflicts exist, or when customizing the form beyond its standard language for clearer control.
New Hampshire law spells out the exact form language in RSA 137-J:20, and three sources publish that statutory version reliably:
Watch for one common headache: some PDF viewers display a blank first page on the fillable version. If that happens, fill out the form in your browser’s PDF viewer or Adobe Acrobat first, then print the completed document rather than printing directly from a preview pane that hasn’t loaded the fields yet.
The New Hampshire form does two jobs at once, which is exactly why the statute merges them into a single document instead of two separate ones.
The Durable Power of Attorney for Health Care section lets you name an agent, and ideally an alternate, to make medical decisions if you can’t. You can also write in specific limits on what your agent is allowed to decide, which matters if there are treatments you want to keep entirely in your own hands regardless of circumstance.
The living will section addresses life-sustaining treatment directly. It walks through scenarios the form labels as “excessively burdensome,” such as being in a permanent unconscious state with no reasonable hope of recovery, and asks you to state your wishes for that specific situation.
Most people complete both sections in one sitting, and the statute anticipates exactly that. The Durable Power of Attorney for Health Care and Living Will form is written as one continuous document precisely because your agent’s authority and your living will instructions are meant to work together, not sit in separate files.
Your advance directive doesn’t activate the moment you sign it. It becomes active only when an attending practitioner documents in your medical record that you lack the capacity to make your own healthcare decisions, according to the Foundation for Healthy Communities. If you regain capacity, whether after surgery, an illness, or an accident, you resume making your own decisions immediately. Your agent’s authority isn’t permanent once triggered; it’s tied to your actual medical status.
It’s worth understanding what your advance directive is not. It’s a legal guidance document, not a medical order. A DNR or POLST form is something your physician writes separately, translating your stated wishes into an actual clinical order the care team can act on. Your advance directive tells your agent and your doctors what you want; it doesn’t replace the order itself.
New Hampshire gives you two valid ways to execute your advance directive, and you only need to satisfy one.
The witness rules have real teeth, and this is where people most often make a mistake. Your named agent cannot witness. Your spouse cannot witness. Anyone who inherits under your will or trust cannot witness. Your attending practitioner and most of that provider’s staff cannot witness. Only one of your two witnesses may be an employee of a health or residential care provider, according to the disclosure statement required under RSA 137-J:19.
The most common pitfall isn’t picking a disqualified witness. It’s forgetting to record witness addresses, or completing the form and then never actually distributing copies to anyone who would need it in an emergency.
Pro Tip: Keep a small card in your wallet noting where your signed original and copies are stored. In a medical emergency, family members rarely know where to look, and a document sitting in a safe deposit box does you no good on a Saturday night.
Without a signed advance directive, New Hampshire law defaults to a surrogate order: spouse first, then adult child, then parent, then sibling, and so on down a statutory list. Whoever is next in that line makes your medical decisions, whether or not that’s the person you’d actually choose.
A surrogate’s authority is narrower and less flexible than an agent’s. You picked your agent and can shape their authority in writing; a surrogate simply steps into a role assigned by statute, regardless of your relationship or your actual wishes.
When family members disagree, or when no eligible surrogate is available or willing, the matter can end up in probate court, where a judge may need to appoint a guardian to make decisions on your behalf. That process takes time and money, and it happens at exactly the moment your family can least afford the delay.
Getting this right takes an afternoon, not a week. Here’s the order that works:
Southern New Hampshire Health and Dartmouth-Hitchcock both allow patients to upload a completed directive into their electronic medical record through patient portals like MyChart, which puts the document in front of clinicians the moment it matters.
Pro Tip: Give your agent a physical copy, not just a promise that one exists somewhere. Emergency rooms move fast, and a document your agent can hand over immediately beats one they have to go home and find.
The standard form works well for straightforward situations. It’s worth a conversation with an attorney when your medical wishes are complicated, your family has a history of conflict, or you want limits on your agent’s authority that are airtight rather than implied. An attorney can also spot where your living will’s language might conflict with restrictions you’ve placed on your DPOAH, which is a real risk once you start customizing the form beyond its default text. Kalie Lydon and the Lydon Law team work directly with clients on estate planning matters like this throughout New Hampshire.
Most guidance treats the advance directive as a legal formality: sign it, file it, forget it. That framing undersells the actual risk. The statute makes the paperwork simple on purpose, two witnesses or a notary, one combined form, so people wouldn’t skip it. But the paperwork was never the hard part.
The hard part is the conversation you have with your agent before anything happens. A form that says “no artificial nutrition in an excessively burdensome situation” means very little if your agent has never heard you explain what that phrase means to you, in your own words, about your own life. I’ve seen how quickly families splinter when an agent is technically authorized but has no idea what their loved one actually wanted.
So prioritize in this order: pick the right agent first, talk with them honestly second, and only then treat the signing itself as the formality it’s designed to be. If your situation involves blended families, contested wishes, or an agent you suspect relatives might challenge later, don’t wait for a crisis to find out your form has a gap. That’s a conversation worth having with an attorney while you still have the time to get it right.
— Kalie
Lydon Law is a straightforward alternative to sorting through legal forms alone when your family situation isn’t simple. We serve clients throughout New Hampshire, from Nashua to Portsmouth, and our estate planning work regularly includes advance directive drafting and review alongside broader planning like guardianship questions and probate concerns. If you’re worried a family member might contest your agent’s authority, or you want limits on your DPOAH that go beyond the standard form, that’s exactly the kind of situation worth a direct conversation with an attorney rather than a generic template.
Bring your completed draft form, a list of who you’re considering as agent and alternate, and any specific medical scenarios you’re unsure how to address. You’ll work directly with your attorney throughout, not get shuffled between staff. Reach out through our contact page to schedule a consultation and get your advance directive reviewed before you need it.
This article is general information, not a substitute for advice from a qualified lawyer. Consult a qualified legal professional about your own circumstances before acting on anything here.
No. Each state sets its own statutory form and execution rules, and New Hampshire’s requires either two witnesses or notarization under RSA 137-J:19. Many states honor an out-of-state directive that was validly executed, but hospitals sometimes ask for a form completed under local law, so it’s worth completing New Hampshire’s version if you live here.
If you split time between states or move permanently, completing a new advance directive under your current state’s rules is the safer path. New Hampshire’s combined DPOAH and living will form, set out in RSA 137-J:20, is written specifically for residents making decisions here.
No. New Hampshire lets you choose between two witnesses or notarization, not both. Notarization by a notary public or justice of the peace is simply the alternative to the two-witness route described in RSA 137-J:19.
The two core components are a Durable Power of Attorney for Health Care, which names an agent to decide for you, and a living will, which states your wishes about life-sustaining treatment directly. New Hampshire combines both into one statutory document rather than treating them as separate forms.
Yes. Lydon Law works with New Hampshire clients on estate planning matters that include advance directive drafting and review, particularly when family dynamics or complex medical wishes call for language beyond the standard form.
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