2. Complete the Combined Registration Agreement & Change Form
The Vermont Advance Directive Registry's Combined Registration Agreement & Change Form gives the registry permission to send a copy of your advance directive and emergency contact information to those authorized to have access. To register an existing advance directive, please fill out the Combined Registration Agreement & Change Form and return both documents to the registry. Learn more on completing this form
Combined Registration Agreement & Change Form
3. Submit your advance directive for registration
Registering a copy of your advance directive is free for Vermont residents. The Vermont Advance Directive Registry (VADR) is a secure online database that is part of the national US Living Will Registry. Registering a copy of your advance directive allows authorized health care facilities and providers quick access when it is most needed. You are not required by law to register a copy of your advance directive.
To register, submit a signed copy of your advance directive with your Combined Registration Agreement & Change Form to the Vermont Advance Directive Registry. Submissions that do not include both forms will be returned by mail for correction. You are not required by law to register an advance directive. However, registered directives give hospitals and other health care providers quick access to them in an emergency.
Return a copy of your advance directive and Combined Registration Agreement & Change Form by email, mail or fax:
Change Your Advance Directive
Access your registered advance directive
You can log into your personal account with the username and password you created when you set up your registry account OR refer to the login instructions on your most recent letter from the registry.
Personal Account Login
You can use your personal account to:
- Download, view and print your document(s).
- Email or fax a copy of your document.
- Confirm that your document is current and still reflects your wishes.
Make changes to your advance directive
- Complete a new advance directive form. The new advance directive must be signed and witnessed. In addition to submitting your new directive to the Registry, send copies of the new directive to anyone with a copy of your previous advance directive.
- Email, mail or fax a copy of the newly signed advance directive form AND an Authorization to Change form* to:
*Submissions that do not include both forms will be returned by mail for correction. You are not required by law to register an advance directive.
Revoke the appointment of a health care agent, suspend or delete your advance directive
- Submit a written statement and a signed Authorization to Change form to the Vermont Advance Directive Registry. Provide a copy of the written statement to anyone with a copy of your advance directive.
- Mail or fax the written statement and form to:
- Mail: Vermont Advance Directive Registry, P.O. Box 2789, Westfield, NJ 07091-2789
- Fax: (908) 654-1919
The Vermont Advance Directive Registry is sensitive to the privacy of registrants, the confidentiality of their information and the documents stored for them.
The registry will provide identifying information, emergency contact information, and an exact copy of the advance directive, provided by the registrant, to any provider with a valid request that complies with the policies and procedures of the registry.
Information transmitted via the internet to your provider or healthcare facility is encrypted and secure.
Questions and Assistance
Vermont Ethics Network
For general information, to request forms or updated stickers for your ID, help with completing an advance directive or form, or about medical decision making:
(802) 828-2909 (Monday to Friday, 9:00 am – 5:00 PM)
U.S. Living Will Registry
For help with your existing account, or to reset your username or password:
(888) 548-9455 (Monday to Friday, 9:00 am – 5:00 PM)
New Wallet ID Cards are automatically sent out ONLY if you have changed your name, primary emergency contact, or date of birth. You will not automatically get a new card for other updates. Order a new wallet card for $5 fee