Form · Advance care · NE

Nebraska advance directive form

The state's own form, from Nebraska Legislature. Rivvi links it; we do not host or change it. Not legal advice.

Quick answer

Nebraska's advance directive form is the 20-404 Declaration (Rights of the Terminally Ill Act form), from Nebraska Legislature. Nebraska publishes a separate health care agent form: 30-3408 Power of Attorney for Health Care (statutory form). Open the state form

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The state form

Form: 20-404 Declaration (Rights of the Terminally Ill Act form)
Publisher: Nebraska Legislature
Law: Neb. Rev. Stat. § 20-404
Form link: nebraskalegislature.gov/laws/statutes.php?statute=20-404
Health care agent form: 30-3408 Power of Attorney for Health Care (statutory form)
Signing (per the source): Witnessed by two adults or a notary public (Neb. Rev. Stat. § 20-404)
Link checked: October 23, 2026

Questions

Where do I get Nebraska's advance directive form?

Nebraska Legislature publishes it: 20-404 Declaration (Rights of the Terminally Ill Act form). The link on this page goes to the state's copy (checked October 23, 2026).

Does Nebraska have a medical power of attorney form?

Nebraska publishes a separate health care agent form: 30-3408 Power of Attorney for Health Care (statutory form).

Does a Nebraska advance directive need witnesses or a notary?

Per the state source: Witnessed by two adults or a notary public (Neb. Rev. Stat. § 20-404). Read the form's own signing instructions before you sign.