All Things Medical
We go through life assuming tomorrow will look much like today, and that if something goes wrong, someone will automatically know what we would want. But the truth is, those closest to us often make medical decisions in the dark. They guess. They second-guess themselves. They argue with each other in hospital hallways because no one ever sat down and put pen to paper about what kind of care matters most.
I have seen it happen more times than I can count. As a New York State Remote Online Notary, I meet hundreds of clients every year. Some come to sign their own health care proxy for the first time. Others are signing documents on behalf of aging parents who live across state lines. And many, many people tell me after the session is over, “I do not know why I waited so long.”
Advance directive notarization is one of the most personally meaningful types of work I do. This is not a tax form. This is not a business partnership agreement. This is you, sitting in your home or your office, making sure your voice will still be heard when you cannot speak for yourself. And with remote online notarization, or RON, you no longer need to schedule an appointment at a bank or find a notary willing to drive to your door. The entire process can happen over a secure video connection, from anywhere, at any time that works for you.
In this guide, I will walk you through everything you need to know. We will cover what advance directives actually are under New York law, why notarization matters even when it is technically optional, how the remote notarization process works from start to finish, and the most common questions I hear from clients – especially those signing Power of Attorney documents for elderly parents.
What Is an Advance Directive?
An advance directive is simply a legal document where you lay out your health care preferences before you are unable to communicate them yourself. The phrase might sound formal and intimidating, but the concept is deeply human. Every person has opinions about how they want to be treated. The difference is, an advance directive puts those opinions into writing and makes them legally enforceable.
New York recognizes three primary types of advance directives: the Health Care Proxy, the Living Will, and the Do Not Resuscitate, or DNR, order. There is also the MOLST form, which stands for Medical Orders for Life-Sustaining Treatment, for people with serious illnesses who want their preferences recorded as physician orders.
The Three Types of Advance Directives in New York
Health Care Proxy
The Health Care Proxy is the cornerstone of advance care planning in New York. Under the New York Public Health Law, Article 29-C, this document allows you to appoint someone you trust as your health care agent. That agent will make medical decisions on your behalf if and when you lose the ability to make them yourself.
Your agent can be any competent adult over the age of 18. You can name an alternate agent as a backup. The authority kicks in once your attending physician determines you have lost decision-making capacity. To sign, you need two witnesses. Neither your agent nor your alternate can serve as a witness. You do not need a notary for the proxy to be valid in New York, but I recommend one anyway – notarization creates a stronger record and removes doubt about the signature.
Living Will
A Living Will is a written statement of your specific health care wishes. While New York has no formal statute governing living wills, the state Court of Appeals has upheld their validity as long as they provide clear and convincing evidence of what you want. You can specify whether you want to be kept on a breathing machine, whether you want tube feeding if you are terminally ill, whether you want CPR if your heart stops, and even whether you want maximum pain relief even if it shortens your life slightly.
I always recommend signing both a Health Care Proxy and a Living Will. The proxy names a decision-maker, and the living will gives that person a detailed roadmap.
Do Not Resuscitate Orders and MOLST Forms
A DNR is a written medical order from your doctor instructing medical professionals not to perform CPR if your heartbeat or breathing stops. In New York, you can have a hospital DNR or a non-hospital DNR recorded on state Form DOH-3474. If you have a serious illness, you may also benefit from a MOLST form, which records your preferences as physician orders on a single document signed by a licensed physician.
Why Notarization Matters for Advance Directives
Here is something many New Yorkers do not realize. Notarization is not legally required for a Health Care Proxy in New York. Two witnesses will do. But I always recommend having your advance directives notarized, and here is why.
First, a notary confirms your identity. I check your government-issued photo identification before I commission any notarization. That means your signature comes with a layer of verification that witnesses alone cannot provide.
Second, notarization prevents future disputes. If a family member later claims the document was signed under pressure or by someone impersonating you, a notarial seal and journal entry serve as clear evidence that the signing happened properly.
Third, some health care facilities and out-of-state institutions automatically recognize notarized documents without question. You do not want your health care agent standing in a hospital arguing about whether your proxy is valid because it lacks a notary seal.
Fourth, the notarization cost is minimal when you use remote online notarization. The entire session takes about 15 to 20 minutes, and you never leave your house.
How Remote Online Notarization Works in New York
Remote Online Notarization, or RON, became permanent New York law in January 2023, governed by Executive Law Section 135-c. Here is how a typical session works.
You book an appointment through a secure scheduling platform. When the session begins, you connect via audio-video technology. I must be physically present in New York State during the session, but you can be anywhere.
I will ask you to show a valid government-issued photo ID, such as a driver’s license or passport. Then we move to Knowledge-Based Verification, or KBA, where you answer four questions about your personal information drawn from credit bureau records. This confirms your identity without physical documents.
Once your identity is verified, we review the document together. I walk you through each section, confirm you understand what you are signing, and verify you are signing voluntarily. Then you sign electronically. The platform captures your signature, applies the notarial seal, and generates a journal entry stored for at least ten years. The session is audio-recorded, and the recording serves as the permanent record.
The beauty of RON is convenience. If you are signing advance directives for yourself, you can do it from your living room. If you are signing for an elderly parent who lives across the country, they can sign from their home while you coordinate from yours.
Power of Attorney Notarization: Common Questions from Clients
A large part of my practice involves Power of Attorney documents. A Durable Power of Attorney allows you to appoint someone to handle your financial and legal affairs, even if you become incapacitated. It is different from a Health Care Proxy because it covers money, property, banking, taxes, and legal claims rather than medical decisions. New York requires separate documents for each, so you cannot combine them.
Clients bring me a wide range of questions about Power of Attorney notarization. Let me address the ones I hear most often.
Question: Do I need a notary for a Power of Attorney in New York?
Yes. A Durable Power of Attorney must be signed by you and acknowledged before a notary public. The notary confirms your identity and your willingness to sign. Without a notarial acknowledgment, the document may not be accepted by banks and financial institutions.
Question: Do I also need witnesses for a Power of Attorney?
Yes, all Powers of Attorney now require two witnesses under New York law. This changed with the 2021 statutory update. One of the witnesses can be the notary, so the RON session covers one of your two required witnesses. The other witness needs to be present as well. Witnesses cannot be the named agent or anyone who would receive gifts under the POA. Also worth noting: the 2021 update eliminated the separate Statutory Gifts Rider – gifting provisions are now included directly in the Power of Attorney modifications section, so the process is simpler than it used to be.
Question: Can I use a remote online notarization for a Power of Attorney?
Absolutely. Remote Online Notarization is fully valid for Durable Power of Attorney documents in New York. The same identity verification process applies, and the notarial seal carries the same legal weight as an in-person notarization. Many clients prefer RON for POA documents because they can sign the same day they receive the paperwork, without taking time off work. For those less comfortable with technology, I also offer in-person notarization appointments with the same thorough document review.
Question: I need to get a Power of Attorney for my elderly parent. What should I keep in mind?
This is the question I hear most often. Setting up a Power of Attorney for an aging parent is one of the most caring things you can do, and it is also one of the most time-sensitive. Your parent must be mentally competent at the time of signing. That means they must understand what the document does, who they are appointing, and what authority they are granting.
If your parent has early-stage dementia or a mild cognitive condition, they can still execute a valid Power of Attorney as long as they understand the basics during the signing. I always ask clients to be honest about their parent’s condition. If there is a recent diagnosis, I recommend getting a brief note from their doctor confirming mental competence at the time of signing. This small step protects against future challenges.
If your parent has already lost capacity, the Power of Attorney is no longer an option. You would need to pursue guardianship through Surrogate’s Court instead, which is a longer and more expensive process.
Question: My parent lives out of state. Can we still complete a remote notarization?
Yes, as long as your parent is in New York during the session or the other state accepts New York-notarized documents. Most states do. For a Health Care Proxy, your parent can appear remotely during my RON session. For a Durable Power of Attorney, the same is true. If your parent lives in a state with different requirements, I can advise on whether additional steps are needed.
Question: Can I be the witness for my parent’s Power of Attorney?
You can be a witness, but you cannot be the witness and the named agent at the same time. If you are the person being appointed as the agent, you need two other people to serve as witnesses. This keeps the process free from conflict.
Question: How long does a Power of Attorney stay valid?
A Durable Power of Attorney remains valid until you revoke it, you become incapacitated and the power is suspended, or you pass away. You can revoke it at any time by signing a revocation notice and notifying all parties who have a copy. If you sign a new Power of Attorney, it automatically cancels the old one.
Question: My parent cannot physically sign. What happens?
If your parent is physically unable to sign, they can direct someone to sign on their behalf in their presence. The notary documents this exception in the acknowledgment. If your parent can mark an X instead of signing, that works too, as long as they are present and directing the signing.
Question: What about a Health Care Proxy for my parent? Do the same rules apply?
A Health Care Proxy for your parent requires two witnesses and does not technically require a notary, but I still recommend one. The same mental capacity requirement applies. Your parent must understand that they are appointing you or someone else to make health care decisions on their behalf.
The Notarization Process Step by Step
Before the session, I send you a secure video conferencing link and ask for a copy of your photo ID. Log in five minutes early with your documents ready. I will greet you, confirm your identity through your ID and KBA questions, and review each document section with you. Once everything is confirmed, you sign electronically. I provide a digital copy and instructions for accessing additional copies. A single document takes about 15 to 20 minutes; a full package including a Health Care Proxy, Living Will, and Durable Power of Attorney typically runs 25 to 35 minutes.
Tips for Preparing Your Advance Directives
First, think carefully about who you appoint as your health care and financial agents. Choose someone who understands your values and lives reasonably close to your primary location. Name an alternate agent for both roles. Discuss your wishes with your family before you sign. Keep copies in accessible places and give them to your agents and your primary care physician. Review your documents every few years or after major life events. In New York, a Health Care Proxy is automatically canceled upon divorce if your spouse is the named agent.
One final tip: free, officially approved forms for Health Care Proxies, Living Wills, and Powers of Attorney are available through the New York State Department of Health and the Attorney General’s office. There is no reason to pay for forms when the state provides them at no cost.
The Time is Now
Planning your health care decisions in advance is one of the most practical and personal things you can do. A Health Care Proxy names a trusted person to make decisions for you. A Living Will spells out exactly what kind of treatment you want. A Durable Power of Attorney protects your financial affairs. And a simple remote notarization ties all of it together with a secure, legally binding record.
You do not need to be elderly to benefit from advance directives. You do not need a serious medical condition. You just need to be someone who values knowing that your wishes will be honored. Every day I meet clients who tell me they wish they had done this sooner. I am here to help you avoid that feeling.
Remote notarization is permanent in New York, secure by design, and faster than any method that came before it. If you have not yet executed your advance directives, or if your documents are years old and need updating, now is the time to act.
Disclaimer: This blog post is provided for informational purposes only and does not constitute legal advice. Advance directive and Power of Attorney requirements can vary based on individual circumstances. Consult with an attorney for guidance specific to your situation before executing any legal documents.