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The Secretary of State has a two-sided form that
you need to fill out that is included with this literature if you want
to file your directive in the Arizona Advance Directive Registry. If
you have any questions about how to register your advance directive with
us, call Business Services at 602.542.6187.
e-mail: ad@azsos.gov
Phone: 602.542.6187 Toll Free: 800.458.5842
INSTRUCTIONS - HOW TO GET STARTED
1. I don’t have an advance directive? How do
I get one?
You need to choose and prepare an advance directive
to file. The directives that can be filed in our office are: a Living
Will, Medical Power of Attorney, or Mental Health Power of Attorney or
a combination of the three. Our office cannot answer questions about
how to prepare directives. Review the information included in this literature
from Health Care Decisions. Staff at Health Care Decisions is available
to assist you and answer any questions you have about health care directives.
2. Already have an Advance Directive?
Read the Registration
Agreement carefully included with this literature, and fill in all
the blank spaces. Attach a copy of your witnessed or notarized advance
directive to the Registration Agreement. The copy of your advance directive
forms must be legible and clearly readable.
Do not send your original advance directive forms.
4. Sign and date the Registration Agreement and return in person or
by mail to:
Arizona Advance Directive Registry
Arizona Secretary of State
1700 W. Washington Street, 7th Floor
Phoenix, AZ 85007
5. When the printed record of the registration is returned by mail, review
it for accuracy.
Depending on the accuracy of the record, check the appropriate box
marking either “no corrections required” or “the information
is not correct”. Sign the form and return it to the Secretary of
State’s Office.
6. Activation
The Secretary of State’s Office will not activate your registration
until a verification form marked “no corrections required” is
received back from you. This verification form will be sent
after you file your advance directive.
7. Issuance of wallet
card and password
A wallet card and password will be issued
once you verify the information in our system is correct. Keep the
wallet card with your file number and password handy. Share your
password with your appointed medical power of attorney,
with your doctor and the hospital or clinic where you receive
medical care.
Forms are also available in an information
packet from the Secretary of State. Contact
us and request Your
Free Guide to Advance Directives.
Back to Advance Directives Home Page ->
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