What is an Advance Health Care Directive?
Advance Health Care Directives are legal documents in which you give written instructions about your health care if, in the future, you cannot speak for yourself.
What are some of the types of Advance Health Care Directives?
- A health care power of attorney.
- A declaration of a desire for a natural death.
- An advance instruction for mental health treatment.
- A declaration of an anatomical gift.
What does each do?
- A health care power of attorney allows you to name a person you trust to make your health care decisions if you cannot make them yourself.
- A declaration of a desire for a natural death (or living will) is document, which states that you desire not to have your life prolonged by extraordinary measures if you have a terminal or incurable illness or if you are in a vegetative state.
- An advance instruction for mental health treatment makes a declaration of instructions, information and preferences regarding your mental health treatment. It also states that you are aware that the advance instruction authorizes a mental health treatment provider to act according to your wishes. It may also outline your consent or refusal of mental health treatment.
- A declaration of an anatomical gift allows anyone over the age of 18 to make a gift by will, organ donor card or other document.
What organs/tissues can be donated?
Now there are several ways to sign-up to be an organ, eye and/or tissue donor in North Carolina, including at the DMV or at
This site allows you to create an online donor record. When you go to the DMV to obtain or renew your driver's license or ID card, your examiner will ask if you would like to become a donor. When you say "yes," a red heart is added to your license or ID card. This heart is legally binding; once you turn 18, your wishes to be an organ and eye donor cannot be overturned by others. It relieves your family of making this decision on your behalf, so please be sure to tell them when you join the registry.
Approximately 3,400 people including neighbors, parents, children, relatives, coworkers, and friends are waiting for transplants in North Carolina
One person can save eight lives through organ donations and enhance more than 50 lives through tissue donations.
Still have questions? Please visit DonateLiveNC.org to learn more or call Donate Life North Carolina at 919-451-7893
Besides submitting the paperwork, is there anything special that must be done?
In each of the above cases, the directive must be notarized before you may submit it to the Secretary of State for filing into the Health Care Registry. The only notarization exception is the Declaration of an Anatomical Gift (Organ Donor Card). This document need not be notarized but does require your signature and two witness signatures.
Can someone at the North Carolina Secretary of State give me legal advice?
The North Carolina Secretary of State is only the Administrator of the Advance Health Care Directive Registry and is prohibited from giving legal advice.
Who should I talk to regarding legal Advance Health Care Directive questions?
Questions about advance health care directives may be answered by consulting with your attorney or other agencies that specialize in end of life care choices and issues.
Am I required by law to file my directive paperwork with the Secretary of State?
Registration of your Advance Health Care Directive is entirely voluntary.
Do I have to use your forms to file a directive?
No. You may file your directives in any format. The forms available on our web page are for the convenience of our customers, not a requirement of the General Statutes. However, please note: the NC Secretary of State is not required to review the document to make sure it complies with the particular statutory requirements applicable to that directive.
What steps should I take to file my paperwork with the Advance Health Care Directive Registry?
Print a Registration Form from our website and fill in the required information. For each directive you wish to register with the North Carolina Secretary of State, please attach a $10.00 fee. Please submit one (1) Registration Form for each directive to be filed. Mail the documents to the North Carolina Department of the Secretary of State, Advance Health Care Directive Registry, Post Office Box 29622, Raleigh, North Carolina 27626-0622.
What happens after you receive my paperwork?
We will set up a profile for you in the Secretary of State Knowledge Base (SOSKB) database and scan your paperwork into the database. We will then send you two (2) Registry Cards that contain your name, file number and password. If you submitted original directive documents, we will return them to you with the Registry Cards. Upon receipt of your Registry Cards, you will be able to access your directives over the Internet here. These sites will be available for use 24 hours a day, seven days a week, 365 days a year.
Who should I notify of my Advance Health Care Directives?
Whether or not you decide to register your directives with the North Carolina Secretary of State, you should notify everyone that needs to know your wishes for any of the above directives. Make sure you tell your doctor, your hospital, agent or surrogate and other family members.
Should I give copies of my card to anyone?
After receiving your Registry Card, you may want to make copies for everyone who you would like to have access to your directives, such as your health care agent, family members and health care providers. You might also consider placing an extra copy in the glove compartment of your vehicle and a copy in any other residences you may have. Directives should be readily available to those who will need to make decisions for you in the event you are unable make decisions for yourself. If you place your Registry Card in a hidden location or a safety deposit box, the directive information may not be nearby when it's needed the most.
What if I change my mind?
You may, at any time, revoke the filing of any of your directives. Simply fill out the Removal Form located on our website and have it notarized. Mail the Removal Form to the North Carolina Secretary of State, Advance Health Care Directive Registry, Post Office Box 29622, Raleigh, North Carolina 27626-0622. We will revoke (delete) your documents that are filed online, and they will no longer be accessible over the Internet. There is no fee for the revocation. The person who originally sent the paperwork is the only one who may revoke a directive.
If I lose my card, can I get it replaced?
Replacement or additional cards may be obtained at minimal cost. Please call our office for the cost of such replacement at 919-814-5400, 8:00 a.m. – 5:00 p.m., Monday through Friday. Please leave a detailed message if the Registrar is unavailable.
What are the differences between the old forms and new forms?
House Bill 634 makes these changes:
- Conflicts between a living will and a health care power of attorney: Allows North Carolinians to choose whether the authority of a health care agent named in a health care power of attorney directive, or the wishes stated in a Living Will, “trumps” in the event of a conflict.
- The Shall Option: Allows North Carolinians to require that their living will be honored.
- Clarification of Statutory Terms: Brings consistency to the terminology used in the living will and health care power of attorney statutes, and makes that terminology clearer to doctors and to patients.
- Improvements in Statutory Forms: Creates more “user-friendly” and understandable non-exclusive statutory forms with more flexibility in exercising choices.
- Clarification of N.C.G.S. § 90-322: Clarifies, in a manner consistent with the other changes made by House Bill 634, the procedures for withholding life-prolonging measures when no living will or health care power of attorney applies.
Miscellaneous Changes and Provisions: These provisions include:
- Clarification of revocation issues
- Clarification of Advanced Directive Registry issues
- Clarification of multi-jurisdictional effectiveness
- Improvements in authority of guardians
- Clarification of health care agent’s authority for post-mortem decisions
- Improvement of informed consent statute
- Clarification of liabilities and responsibilities of health care providers
- Improvement in execution requirements
MOST: Adoption of MOST, a new portable medical order.
Are the older forms still effective or do I need to redo them?
Nothing in House Bill 634 invalidates old statutory forms or old “custom” forms. Those forms will still apply according to those terms. North Carolinians who have executed forms under the old statute may, of course, wish to consider executing new forms to more clearly express their intent.
What is a DNR Form?
The Department of Health and Human Service’s “Do Not Resuscitate” (DNR) form can be ordered by application to the Office of Emergency Medical Services, Division of Facility Services: Attention: DNR Order, 2707 Mail Service Center, Raleigh, North Carolina 27699-2707 or you may print out the application online at http://facility-services.state.nc.us/EMS/dnrordfm.pdf. You may also contact the Office of Emergency Medical Services at (919)855-3935. The DNR form is yellow and is to be visible to the staff.
What is a MOST Form?
Medical Order for Scope of Treatment (MOST) is a Physician’s Order based on the person’s medical condition and wishes. The MOST form is to be sent with the patient/resident when transferred or discharged. It is effective for one year, but can be updated so that it can remain in effect longer. The form is signed by the physician, Physician’s Assistant, Nurse Practitioner as well as the patient or representative agent.
Where do I get a MOST Form?
The MOST form is only available through your physician, physician’s assistant or nurse practitioner.
Can the MOST Order and the DNR Form be placed on the Secretary of State Advance Health Care Directive Registry?
No – Only the original documents are valid for use with health care providers.
How do I contact the Advance Health Care Directive Registry section?
Mailing AddressAdvance Health Care Directive Registry
Department of the Secretary of State
Post Office Box 29622
Raleigh, North Carolina 27626-0622
Carrier Envelopes2 South Salisbury Street
Raleigh, North Carolina 27601-2903