Advanced Directive Form
Use a Advanced Directive Form template to make your document workflow more streamlined.
What an advanced directive form does
An Advanced Directive Form records a person’s healthcare preferences and may identify someone authorized to make decisions if the person cannot communicate. The signer completes treatment instructions, reviews the designated representative information, and signs according to applicable state requirements. With signNow, a prepared PDF can be uploaded, fillable fields can be detected or placed, and signature or acknowledgment fields can be routed to the required participants. The completed directive and audit trail can then be stored for authorized retrieval, subject to state witness, notarization, and provider policies.
How advanced directive signing works
signNow turns the advanced directive PDF into a controlled signing workflow while preserving the completed document and its signing history.
Upload document: Upload the blank or completed directive PDF. Add fields: Place signature, date, and acknowledgment fields. Send for signing: Send the directive to each authorized signer. Archive securely: Store the completed record with its audit trail.
What the advanced directive audit trail records
An audit trail documents who interacted with the advanced directive, when actions occurred, and how the completed record can be reviewed or exported.
Authenticate signer:
Capture timestamp:
Hash document:
Seal record:
Track history:
Retrieve evidence:
Configure advanced directive signing controls
Use identifiable signers, a complete audit trail, defined retention, and encrypted transmission for advanced directive records.
| Setting | Recommendation |
|---|---|
| Authentication method | Email verification with SMS OTP |
| Signature type | Typed or drawn electronic signature |
| Audit trail | Capture timestamps, IP address, and actions |
| Document retention | Retain six years for HIPAA records |
| Encryption | TLS 1.2/1.3 and AES-256 |
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Signer authentication for advanced directives
PKI:
X.509 certificates:
Two-factor authentication:
SMS OTP:
ID verification:
Consent evidence:
Mobile options for advanced directives
signNow provides iOS and Android mobile apps for reviewing and signing an Advanced Directive Form. Mobile workflows can use offline signing and camera-based document capture when the care setting requires a phone or tablet.
Mobile apps iOS and Android apps Offline mode Offline signing available Camera capture Camera document capture
Mobile access helps patients, representatives, and clinical staff review an Advanced Directive Form away from a workstation. Organizations should manage device access, confirm connectivity before sending, and apply state-specific witness or notarization procedures separately from the electronic signing workflow.
Legal standing of an advanced directive
An electronic advanced directive may be admissible when the signer demonstrates intent, consents to electronic records, can be identified, and the record remains reproducible under ESIGN and applicable state law. Wills, codicils, testamentary trusts, court orders, and family-law decrees remain outside ESIGN’s federal coverage.
State rules and document exclusions
State execution rules
Wills excluded
Court documents
Real-estate deeds
Execution defect
How long to retain an advanced directive
Retention depends on the record’s legal and clinical context. Use the applicable state and provider policy, and apply the six-year HIPAA period when the record is covered by 45 CFR §164.530(j).
Six years for HIPAA records
No IRS period applies
State period if longer
Provider policy period
Documented version history
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Advanced directive signing questions
Use these answers to resolve execution, authentication, plan, privacy, and retention questions before sending an Advanced Directive Form.
Upload the Advanced Directive Form as a PDF, then use signNow’s field tools to place signature, date, and acknowledgment fields. Auto-detection can reduce setup time, but review every field against the state-specific directive before sending.
An electronic signature does not automatically replace required witnesses or notarization. Check the patient’s state execution law or provider policy, then use signNow for permitted signatures while completing any required in-person formalities separately.
Business includes legally binding eSignatures, templates, mobile apps, and audit trails at $8/user/month with annual billing. It does not include Business Premium’s bulk send or Enterprise’s advanced signer authentication.
signNow lists HIPAA compliance with a BAA required. Confirm that the organization has the BAA and configure access controls before routing an Advanced Directive Form containing protected health information.
Use SMS OTP or another configured authentication method when email-only identity evidence is insufficient. Advanced signer authentication is listed with Enterprise, while available controls depend on the selected plan and configuration.
For a consumer-facing electronic record, ESIGN requires disclosure of the right to paper, access to the electronic format, and procedures for withdrawing consent under 15 U.S.C. §7001(c). Configure and document that process before sending.
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