Rhode Island Advance Directive Form

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A Rhode Island advance directive combines a medical power of attorney and a living will into one (1) document so that an agent is clear on how to fulfill a principal’s health-related wishes. The medical power of attorney grants the agent permission to make decisions on behalf of the principal, whereas the living will contains life-sustaining treatment preferences. The agreement is only used for planning purposes and goes into effect if the principal suffers a medical event that renders them incapacitated (or unable to communicate effectively).



The appointed agent must be at least eighteen (18) years of age and a Rhode Island resident. By signing, they agree to make health care decisions for the principal if they cannot do so for themselves. The appointed agent cannot be a health or primary care provider or employee of the health care provider unless they are a relative. They also cannot be an assisted living facility operator or nonrelative employee.

State laws: Chapter 23-4.10 & Chapter 23-4.11

Signing requirements (§ 23-4.10-2 & § 23-4.11-3(a)): The form must be signed by the principal and acknowledged by a Notary Public or two (2) qualified witnesses.