Arizona Healthcare Directives Registration Agreement

Filing this agreement ensures that your medical wishes are accessible to licensed health care professionals when you can’t speak for yourself.

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📌 What Is the Registration Agreement?

The Registration Agreement is the official form used to file your health care directives with the Arizona Healthcare Directives Registry (AzHDR) — a secure database managed by the Arizona Secretary of State. Filing this agreement ensures that your medical wishes are accessible to licensed health care professionals when you can’t speak for yourself.

Once registered, you’ll receive a wallet-sized membership card with access instructions for emergency providers.


✅ Here is the Free Fillable PDF for the Agreement

Registration Agreement


✅ What You Can Do with the Agreement

You can use the Registration Agreement to:


🧾 What You’ll Need to Complete It

Before you start, gather the following:


🧠 Important Concepts to Know


📦 How to Submit the Registration Agreement

  1. Complete the online or paper form with your personal and contact information.

  2. Select the action you want (e.g., file a new directive, request a new card).

  3. Upload or attach your completed health care directive(s).

  4. Sign the agreement and include a notarized form if required.

  5. Submit it to the Arizona Secretary of State (by mail or online, depending on format).

Once approved, you’ll receive:


💡 Tips to Make It Easy


📬 Where to Send Your Forms

Arizona Secretary of State – Advance Directive Registry Mail your forms: Arizona Healthcare Directives Registry – Contexture 2901 N. Central Ave., Ste. 1100 Phoenix, AZ 85012

Email your forms: azhdr@contexture.org


👀 What Happens After You Submit?


👥 Need Help?

If you have questions or want someone to walk you through the process, Helpful can guide you. Please contact us today here

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