Living Will Forms

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Living Will Forms

A living will is a type of medical directive that allows a person to specify health care preferences should they be unable to communicate their wishes. It outlines the patient’s choices regarding life-sustaining treatments – such as CPR, mechanical ventilation, and artificial nutrition and hydration – as well as end-of-life wishes, including hospice care and funeral arrangements.

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Last updated August 5th, 2025

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A living will is a type of medical directive that allows a person to specify health care preferences should they be unable to communicate their wishes. It outlines the patient’s choices regarding life-sustaining treatments – such as CPR, mechanical ventilation, and artificial nutrition and hydration – as well as end-of-life wishes, including hospice care and funeral arrangements.

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Alternate Names

  • Health Care Directive
  • Directive to Physicians
  • Medical Directive

By State

What is a Living Will

A living will is a document that any adult can complete to indicate how they would like to be taken care of after experiencing a serious medical event that leaves them incapacitated.
The document is frequently combined with a medical power of attorney, a form that appoints a trusted person to communicate with doctors on a patient’s behalf. Together, they create an advance directive.

Living Will

  • Written instructions for end-of-life care
  • Only comes into effect when terminally ill or permanently unconscious
  • Does not cover a person’s estate
VS

Living Trust

  • Estate planning document
  • Creates an account that holds a person’s property during the principal’s life
  • After death, the trust is distributed as per the principal’s instructions

Living Will

  • End-of-life health care preferences
  • Only medical matters, not estate distribution
  • Terminates upon principal’s death
VS

Last Will and Testament

  • Instructions for estate distribution
  • Does not contain health care instructions
  • Comes into effect only after the principal’s death

How to Make a Living Will

Because each state has different laws governing health care directives, the appropriate state form should be used to create a living will. The principal must select their preferred health care measures and sign the form. Living wills typically must also be signed by witnesses or a notary public to be legally binding.

The principal should retain a copy for themselves and distribute copies to their physician, health care agent (if applicable), and trusted family members.

Sample

Download: PDF, MS Word, ODT

LIVING WILL
(HEALTH CARE DIRECTIVE)

This form was completed and signed on [MM/DD/YYYY].

I, [PRINCIPAL NAME], with a street address of [PRINCIPAL ADDRESS], city of [PRINCIPAL CITY], county of [PRINCIPAL COUNTY], state of [PRINCIPAL STATE], with the last four digits of my social security number (SSN) being [####] (hereinafter referred to as the “Principal”) desire to advise my doctors and medical providers of my wishes for my health care in the event I am not able to communicate my wishes.

A. LIFE SUPPORT. I desire that my doctor make a concerted effort to return me to an acceptable quality of life using available treatments and therapies. However, if my quality of life becomes unacceptable as I have defined below and my doctors have determined that my condition will not improve (is irreversible), I direct that all treatments that extend my life be withdrawn.

An unacceptable quality of life means (initial and check all that apply):

[INITIALS] ☐ – Chronic coma or persistent vegetative state
[INITIALS] ☐ – No longer able to communicate my needs
[INITIALS] ☐ – No longer able to recognize family or friends
[INITIALS] ☐ – Total dependence on others for daily care
[INITIALS] ☐ – Other: [LIST OTHER UNACCEPTABLE QUALITY OF LIFE SITUATIONS]

Initial and check only one:

[INITIALS] ☐ – Even if I have the quality of life described above, I still wish to be treated with food and water by tube or intravenously (IV).
[INITIALS] ☐ – If I have the quality of life described above, I do NOT wish to be treated with food and water by tube or intravenously (IV).

B. CERTAIN LIFE-SUSTAINING TREATMENT (optional). Some people do not wish to have certain life-sustaining treatments under any circumstance, even if recovery is a possibility. Check and initial beside treatments below, if any, that you do not wish to have under any circumstances:

[INITIALS] ☐ – Cardiopulmonary Resuscitation (CPR)
[INITIALS] ☐ – Ventilation (breathing machine)
[INITIALS] ☐ – Feeding tube
[INITIALS] ☐ – Dialysis
[INITIALS] ☐ – Other: [LIST OTHER LIFE-SUSTAINING TREATMENTS]

C. END OF LIFE WISHES (hospice, funeral, etc.). When I am near death, it is important to me that: [LIST END-OF-LIFE WISHES]

I have signed this document on [MM/DD/YYYY].

Principal Signature: ________________________ Date: [MM/DD/YYYY]
Print Name: [PRINTED NAME]

WITNESS ACKNOWLEDGMENT 

On the date set forth above, I hereby state as follows:

The above-named person is personally known to me, and I believe him/her to be of sound mind and to have voluntarily executed this document. I am at least 18 years old and not related to him/her by blood, marriage, or adoption. To my knowledge, I am not a beneficiary of his/her will or any codicil, and I have no claim against his/her estate. I am not directly involved in his/her health care.

Witness 1 Signature: ________________________ Date: [MM/DD/YYYY]
Print Name: [PRINTED NAME]
Address: [ADDRESS]
Phone Number: [PHONE NUMBER]

Witness 2 Signature: ________________________ Date: [MM/DD/YYYY]
Print Name: [PRINTED NAME]
Address: [ADDRESS]
Phone Number: [PHONE NUMBER]