Search:
Office of Secretary of State 
Elections / Elleciones
Business Filings
Notary
Advance Directives
Publications
Rules Filings
Legislative Filings
News Room
Kids Page
 
Print This Page!

 

 

 

 

The Arizona Advance Directive Registry is a database for the storage of advance directives (Living Will, Medical Power of Attorney, and Mental Health Power of Attorney).

Download our free Guide to Filing Advance Directives with our office. Requires Adobe Acrobat Reader

Quick Facts

  • The Arizona Secretary of State oversees Registry filings, its security, and operations.
  • Participants and their loved ones may use the Registry to look up registered directives.
  • Heath care providers may use the Registry to look up registered directives using the information provided to them by the participant.
  • The Arizona Advance Directive Registry was created in May 2004 by the Arizona State Legislature.

How do I get started to participate in this program?

Prepare an Advance Directive

  • Choose and prepare an Advance Directive to file.
  • The Directive can be a Living Will, Medical Power of Attorney, or Mental Health Power of Attorney or a combination of the three.
  • Read the information provided by Health Care Decisions, our partners in the Registry to help you choose and prepare an Advance Directive. If you do not feel comfortable in preparing a Directive, contact an attorney.
  • Once you have completed your Advance Directive, make sure it is properly signed by a witness or notarized.

Register your Advance Directive

  • Complete the Registration Agreement and return it to our office with your Advance Directive.
  • There are no fees for this service.
  • There is no "online" registration. A copy of the Advance Directive must be mailed to the office.

Instructions to register an Advance Directive

    1. Print a copy of the Registration Agreement
        This form is in pdf. Requires a free Adobe Acrobat Reader.

    2. Read the Registration Agreement carefully, and complete the form.

    3. Attach a COPY of your witnessed or notarized Advance Directive to the Registration Agreement.

    Do not send your original advance directive forms.

    The copy of your advance directive forms must be legible and clearly readable.

    4. Sign and date the Registration Agreement and return it by mail to:

    Arizona Advance Directive Registry
    Arizona Secretary of State
    1700 W. Washington Street – 7th Floor
    Phoenix, AZ 85007

    If you would like to file the Registration Agreement and Advance Directive in person visit our Customer Service Center.

Verification Process of Registration

    1. When the printed record of the registration is returned by mail, review it for accuracy.

    • If the information is accurate check the box “no corrections required”
    • If the information is inaccurate check the box “the information is not correct”.

    2. Sign the confirmation form and return it to the Secretary of State's Office.

    3. If needed the Secretary of State's Office will make corrections as specified by the program participant. The Secretary of State's Office will not activate your registration until a verification form marked “no corrections required” is received.

Activation of Registration

    1. Once the office receives verification that the information on file is correct, a wallet card will be issued.

    2. Keep the wallet card with file number and password handy.

Contact Your Health Care Provider

    Share your password with your appointed medical power of attorney, with your doctor and the hospital or clinic where you receive medical care.

Thank you for your interest in Arizona’s Advance Directive Registry.

 

LOG IN Lock

Program Participants
Log in to View Your Advance Directive

 
 
 

If you have questions, please contact the Office of the Arizona Secretary of State:

Email: Email Us
Phone: 602-542-6187
Toll Free: 800-458-5842

Arizona Secretary of State
Advance Directives
1700 W. Washington, 7th Floor
Phoenix, AZ 85007

 
LEGEND   = This link will bring you to another web site Get Adobe Reader = PDF document requires Adobe Reader

 
  
©2005 Arizona Secretary of State, All Rights Reserved