Updated August 3, 2026. Quick answer: Missouri calls this instrument declaration. 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 | declaration |
|---|---|
| Witnesses required | 2 |
| Witnesses or notary? | Witnesses only — no notary path stated |
| Who may NOT witness | A witness may not be the person who signed the declaration on behalf of and at the direction of the declarant. No other disqualifications (relatives, heirs, attending physician, facility employees) were found in the sections reviewed. |
| If you are in a care facility | No special rule found in the text we read |
| Authority | Mo. Rev. Stat. §459.015 |
What the statute says
If not wholly in the declarant’s handwriting, signed in the presence of two or more witnesses at least eighteen years of age neither of whom shall be the person who signed the declaration on behalf of and at the direction of the person making the declaration.
— Mo. Rev. Stat. §459.015
The form
We did not find an official state form. That does not mean none exists. A directive does not require a state form to be valid, provided it is executed as the statute requires.
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
Missouri also has a separate Durable Power of Attorney for Health Care statute (Ch. 404) not reviewed here; this record covers only the Ch. 459 declaration. §459.025 (reviewed) contains no additional witness-disqualification language, but other sections of Ch. 459 were not individually checked.
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.