Colorado Advance Directives and Medical Power of Attorney

Colorado does not use one combined advance directive form. State law spreads healthcare planning across four separate instruments: a living will under the Colorado Medical Treatment Decision Act (C.R.S. § 15-18-101 et seq.), a medical durable power of attorney under the Colorado Patient Autonomy Act (C.R.S. §§ 15-14-503 to 15-14-509), a CPR directive (C.R.S. Title 15, Article 18.6), and a MOST form (C.R.S. Title 15, Article 18.7). A fifth rule, the proxy decision-maker statute at C.R.S. § 15-18.5-103, decides who speaks for you when none of those documents exists.

Use this Colorado advance directive guide as a planning map, not as legal advice or a finished form. The wording you need depends on your health, your family, and your wishes, and a Colorado estate-planning attorney can confirm the documents say what you mean. For the money side of incapacity planning, pair this page with the Colorado power of attorney guide.

The Four Colorado Documents

Each instrument answers a different question, and you can hold more than one at the same time.

Most planning starts with the first two. The living will carries your end-of-life instructions, and the MDPOA names your decision-maker. Colorado lets you combine a living will and an MDPOA into a single document, as long as the combined document satisfies both statutes (C.R.S. § 15-18-104(7)). The CPR directive and the MOST form are medical-order documents that usually enter the picture with serious illness, because a provider must sign them.

The Colorado Living Will

Under C.R.S. § 15-18-104, any adult with decisional capacity may sign a declaration directing that life-sustaining procedures be withheld or withdrawn if two things later become true at the same time: you have a terminal condition or are in a persistent vegetative state, and you lack the capacity to accept or reject treatment. A terminal condition means an incurable or irreversible condition where life-sustaining procedures would serve only to prolong the dying process (C.R.S. § 15-18-103(14)).

The declaration can carry separate instructions on artificial nutrition and hydration: stop it, continue it for a specified period, or continue it (C.R.S. § 15-18-104(3)). Whatever you write, a physician or advanced practice registered nurse may continue artificial nutrition and hydration to the extent needed for comfort and pain relief (C.R.S. § 15-18-104(4)). The declaration can also include organ-donation statements, HIPAA-style designations of people your doctors may talk to, and individual medical directives (C.R.S. § 15-18-104(6), (8), (9)).

A living will does not switch on at signing. Before anyone acts on it, your attending physician and one other physician must examine you, find the terminal condition or persistent vegetative state plus the lack of decisional capacity, and certify that in writing in your medical record. The physician must then make a reasonable effort to notify your MDPOA agent or, without regard to order, your spouse, a designated beneficiary, an adult child, a parent, a sibling, or another person you designated in writing. If no one files a court challenge within 48 hours of the certification, the declaration is carried out (C.R.S. § 15-18-107). A validity challenge goes to the district court of the county where you are located, or to the Denver Probate Court in the City and County of Denver (C.R.S. §§ 15-18-103(5), 15-18-108).

How to Sign a Living Will: Witnesses or a Notary

Since a 2021 amendment (SB 21-195, effective May 7, 2021), C.R.S. § 15-18-106 gives you two alternative paths. A declaration must be either:

• signed by you in the presence of two witnesses, or
• signed by you and acknowledged before a notary public or another individual authorized to take acknowledgments.

You need one path, not both. Notarization replaces the witnesses, and witnesses replace the notary.

The disqualification list in C.R.S. § 15-18-105 applies to the witnesses and to the notary (C.R.S. § 15-18-106(2)). None of these people can fill the role:

• your attending physician or any other physician
• an employee of your attending physician or of the healthcare facility where you are a patient
• a person with a claim against any portion of your estate at your death
• a person who knows or believes they would take part of your estate as a will beneficiary or heir at law

If you cannot physically sign, another person may sign in your presence and at your direction, subject to the same disqualification list (C.R.S. § 15-18-105).

One stale-form warning: Colorado repealed its sample statutory living will form in 2021 (SB 21-193 repealed the form at C.R.S. § 15-18-104(2), effective September 7, 2021). Many websites still print that old form. A declaration does not need any particular template, so judge a form by whether it meets § 15-18-106, not by whether it matches an outdated sample.

The Medical Durable Power of Attorney

The MDPOA is Colorado's healthcare-agent document. Under C.R.S. § 15-14-506, your agent may consent to or refuse medical treatment for you, including artificial nourishment and hydration, and holds the same power to make medical treatment decisions you would have if you had capacity. The statute treats the agent as your designated representative with the same right of access to your medical records that you hold yourself.

Rules that shape how the MDPOA works:

• It operates only when you lack decisional capacity. While you can decide, you decide. No agent may consent to or refuse treatment over your objection, and you keep the right to revoke the agent's authority at any time (C.R.S. § 15-14-506(4)(a)).
• The agent follows your instructions first. The agent must act within the document's terms and your known wishes, and only falls back to your best interests when neither gives an answer (C.R.S. § 15-14-506(2)).
• The capacity finding is documented. A court or your attending physician, or an advanced practice registered nurse who has collaborated with a physician, determines the lack of decisional capacity and records specific findings on its cause, nature, and projected duration in your medical record (C.R.S. § 15-18.5-103(2)).
• No witnesses or notary are required by statute. The Patient Autonomy Act prescribes no execution formalities for an MDPOA. Signing before a notary is still smart practice, because hospitals and out-of-state providers accept a notarized document more readily, and C.R.S. § 15-14-509 presumes a Colorado MDPOA is intended for recognition in other states.
• An MDPOA does not override your living will by default. Unless the documents say otherwise, the MDPOA does not modify a declaration under the Medical Treatment Decision Act (C.R.S. § 15-14-506(6)(b)).

The MDPOA covers medical decisions only. Authority over your bank accounts, property, and bills comes from a separate financial power of attorney under the Uniform Power of Attorney Act, which the Colorado power of attorney guide covers.

Who Decides If You Have No Documents

Colorado handles the no-directive case differently from most states. Instead of ranking family members in a fixed priority order, C.R.S. § 15-18.5-103 uses selection by consensus.

When your attending physician determines you lack decisional capacity and no guardian, MDPOA agent, or designated beneficiary holds authority, the physician makes reasonable efforts to locate the interested persons: your spouse, either parent, any adult child, sibling, or grandchild, or any close friend. Those people must then try to agree on one proxy decision-maker from among themselves. The statute points them toward the person with a close relationship to you who is most likely to know your current wishes (C.R.S. § 15-18.5-103(4)(a)). The proxy cannot be your attending physician (C.R.S. § 15-18.5-103(1.5)(b)).

Limits sit on top of the consensus rule:

• If the interested persons cannot agree, or someone disagrees with the proxy's selection or decisions, the tiebreaker is a guardianship proceeding, which only the interested persons may start (C.R.S. § 15-18.5-103(4)).
• A proxy may consent to withholding or withdrawing artificial nourishment and hydration only if the attending physician and a second independent physician trained in neurology or neurosurgery certify in the medical record that it would merely prolong the act of dying and is unlikely to restore independent neurological functioning (C.R.S. § 15-18.5-103(6)(a)).
• If no interested person is willing and able to serve, the attending physician may designate another willing physician as proxy, but only after an independent second capacity determination, a consensus with the facility's medical ethics committee, and documentation in the medical record (C.R.S. § 15-18.5-103(4)(c)).

The planning takeaway: the consensus process can stall, split a family, or end in a guardianship petition. Signing an MDPOA keeps the choice of decision-maker in your hands and helps your family avoid court. The Colorado guardianship planning guide explains how directives head off adult guardianship.

Changing or Revoking Your Documents

Colorado makes revocation easy and biased toward the patient:

• Living will. Revoke it orally, in writing, or by burning, tearing, canceling, obliterating, or destroying it (C.R.S. § 15-18-109). Concealing or defacing someone else's declaration, or willfully withholding knowledge of a revocation, is a class 2 misdemeanor (C.R.S. § 15-18-113).
• MDPOA. You always keep the right to revoke the agent's authority and to decide for yourself while you have capacity (C.R.S. § 15-14-506(4)(a)).
• Divorce revokes a spouse agent. If you named your spouse as MDPOA agent, a later divorce, dissolution, annulment, or legal separation automatically revokes that appointment unless the document expressly says otherwise. The rest of the MDPOA survives (C.R.S. § 15-14-506(5)(c)). Sign a new document naming someone else so you are not left without an agent.
• CPR directive. The person it covers may revoke it at any time. An agent, guardian, or proxy may revoke it only if one of them executed it in the first place (C.R.S. § 15-18.6-107).
• MOST form. It can be revised or revoked under C.R.S. § 15-18.7-107, and a provider may revise it only for a changed medical condition or medical inappropriateness, after consulting you or your authorized surrogate.

After any change, hand the new versions to your agent, your doctor, and any facility holding the old ones.

A Simple Planning Sequence

1. Choose your MDPOA agent and a backup, and ask them first.
2. Sign the MDPOA, ideally before a notary even though the statute does not require it.
3. Decide whether you want a living will, and sign it with two qualified witnesses or a notary.
4. Consider combining both into one document under C.R.S. § 15-18-104(7) if your attorney recommends it.
5. If serious illness is already in the picture, talk with your doctor about a CPR directive or a MOST form, since both need a provider's signature.
6. Give copies to your agent and your doctors, and review the set after any major life change, especially marriage or divorce.

Healthcare directives cover decisions while you are alive. To control what happens to property afterward, start with how to avoid probate in Colorado, and see the Colorado probate guide for how estates move through the district courts and the Denver Probate Court.

When to Get Help

Plenty of Coloradans sign an MDPOA and a living will without trouble. Bring in a licensed Colorado attorney when:

• family conflict makes a future consensus-proxy fight or guardianship petition likely
• you want one combined document that satisfies both the Medical Treatment Decision Act and the Patient Autonomy Act
• an old pre-2021 form, an out-of-state directive, or a repealed-form template is in the mix
• a facility or provider refuses to honor a document
• you need the financial side handled at the same time

This guide is general information about Colorado healthcare directives. It is not legal advice. Confirm anything that affects your situation with the current Colorado Revised Statutes, your healthcare providers, or a licensed Colorado attorney.

Sources

Sources:

• Title: C.R.S. Title 15, Article 18, Colorado Medical Treatment Decision Act (§§ 15-18-101 to 15-18-113), including the SB 21-195 witnessed-or-notarized amendment and the SB 21-193 repeal of the sample form. Publisher: Colorado General Assembly, Colorado Revised Statutes (leg.colorado.gov). Publication Date: Current edition, accessed 2026-06-10. URL: https://leg.colorado.gov/colorado-revised-statutes
• Title: C.R.S. §§ 15-14-503 to 15-14-509, Colorado Patient Autonomy Act (medical durable power of attorney). Publisher: Colorado General Assembly, Colorado Revised Statutes (leg.colorado.gov). Publication Date: Current edition, accessed 2026-06-10. URL: https://leg.colorado.gov/colorado-revised-statutes
• Title: C.R.S. § 15-18.5-103, Proxy decision-makers for medical treatment authorized. Publisher: Colorado General Assembly, Colorado Revised Statutes (leg.colorado.gov). Publication Date: Current edition, accessed 2026-06-10. URL: https://leg.colorado.gov/colorado-revised-statutes
• Title: C.R.S. §§ 15-18.6-101 to 15-18.6-108 (CPR directives) and §§ 15-18.7-101 to 15-18.7-110 (Medical Orders for Scope of Treatment). Publisher: Colorado General Assembly, Colorado Revised Statutes (leg.colorado.gov). Publication Date: Current edition, accessed 2026-06-10. URL: https://leg.colorado.gov/colorado-revised-statutes
• Title: Colorado Revised Statutes, Title 15, Probate, Trusts, and Fiduciaries (official Office of Legislative Legal Services uncertified printout). Publisher: Colorado Office of Legislative Legal Services. Publication Date: Current edition, accessed 2026-06-10. URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-15.pdf