Updated August 3, 2026. Quick answer: Maryland calls this instrument advance directive, health care agent. To execute it you need 2 witnesses — and the state requires Witnesses only — no notary path stated. Getting that conjunction wrong is the most common way a directive fails when it is needed.
The execution box
| What the state calls it | advance directive, health care agent |
|---|---|
| Witnesses required | 2 |
| Witnesses or notary? | Witnesses only — no notary path stated |
| Who may NOT witness | The health care agent may not serve as a witness; at least one of the two witnesses must not be knowingly entitled to any portion of the declarant’s estate or to any financial benefit by reason of the declarant’s death. Employees of health care facilities, nurse practitioners, physician assistants, and treating physicians ARE permitted to witness if acting in good faith. |
| If you are in a care facility | No special rule found in the text we read |
| Authority | Md. Code Ann., Health-General §5-602(c) |
What the statute says
subscribed by two witnesses in the physical presence or electronic presence of the declarant
— Md. Code Ann., Health-General §5-602(c)
The form
There is an official state form, published by the state and free: Md. Code Ann., Health-General §5-602(c). You should not have to buy one.
Why the witness rules matter more than the wording
People spend their effort on what the directive says and almost none on how it is signed. A directive that expresses your wishes perfectly but was witnessed by someone the statute disqualifies may not be honoured. The disqualification lists exist because the people most likely to be in the room — family, the treating doctor, facility staff — are the people with an interest in the outcome.
Two practical consequences. Ask who is signing before the appointment, not during it. And if you are already in a hospital or care facility, check the facility rule row above — several states add a requirement that applies only to patients and residents, and it is the one nobody mentions.
This is the medical instrument, not the financial one
A financial power of attorney is a different document with different execution rules. Having one does not give anyone authority over your medical care, and having this one gives nobody authority over your money. Most people need both, and they are executed separately.
What could not be verified
An oral directive has a different, lighter formality (attending physician/PA/NP plus one witness); this record covers the written/electronic directive path only.
Related: all states compared · living will versus healthcare proxy · what it costs.
General information drawn from state statutes and official state materials, not legal or medical advice. Advance-directive law is STATE law and the execution requirements differ in ways that decide whether a document works: some states require witnesses AND a notary, some accept either, and the list of people who may not witness varies. A directive executed the wrong way may not be honoured when it matters. Many states publish a free official form – you should not have to buy one.