Complete this free living will form according to your preferences
and know that it will stand as your wish in a medical crisis.
It should always be your choice!
It is easiest to copy the whole document into a word editing program and then deleting the options which you do not want from the living will template supplied here.
You can add any other instructions - as long as they are not against the law and clearly convey your meaning - they must be honored by an attending physician.
We use the terms living will or advance health directive interchangeably. Some jurisdictions have a preference for one or the other term but they refer to the same legal document.
For more information and guidelines on compiling your document,
please refer to our Free Living Will page.
You can also appoint an Agent in a Medical Power of Attorney. He/she can then make decisions about your personal care or medical decisions on your behalf.
Note: Any such decisions made must be according to your living will or health directive.
If you need step-by-step help drafting your document and want to use a template that is specifically tailored to your country or state, then visit LawDepot.
Make use of their Free 1 Week Trial option to see how it can work for you. Click on the link to take you to LawDepot.
This directive is made by me _______________________________
Identification / Social Security Number _________________________________
at a time when I am of sound mind and after careful consideration.
If the time comes when I can no longer take part in decisions for my own future, let this Directive stand as testament to my wishes.
1. I do not want my life prolonged by artificial means if:
a. There is no reasonable prospect of my recovery from physical illness.
b. If impairment is expected to cause me severe distress.
c. If I am rendered incapable of rational existence.
I want my life prolonged as long as possible within acceptable medical practice and standards.
2. I direct that I receive whatever quantity of medication that may be required to keep me from pain and distress even if the moment of death is hastened.
This directive is signed by me on this ________day of _______________20____ at this location __________________________ in the presence of the two undersigned witnesses.
Declaration of Witnesses
As witnesses we declare that the above named person is personally known to us, appears to be of sound mind and signed this directive willingly and free of undue influence or duress. We are legal adults and are not related to him / her by blood, marriage or adoption and are not appointed as agents in this directive. To our knowledge we are not beneficiaries of his / her estate and have no claims against his / her estate. We are not directly involved in his / her health care. We declare that he / she signed this will in our presence as we signed as witnesses in the presence of each other, all being present at the same time. Under penalty of perjury we declare these statements to be true and correct on this _________ day of ____________________ 20____ at this location _________________________________.
You can add more numbered paragraphs to this free living will and issue detailed instructions on whether you do or do not want:
...or any other treatment or nutrition according to your beliefs.
Note:Do you also have a Last Will and Testament in place? Refer to the information on this page: How to Write a Will where you can find links to a variety of free legal will forms and other estate information.
Note:Once you've edited this free living will form, then it is advisable to have a copy of your living will close by, especially if you directed that your organs may be used for transplant and every minute counts.
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