Living Will Declaration
If you want to create a living will to describe your wishes for life-prolonging treatment, we have a few options to help.
Ready to create your living will? We've got a few options to help. Choose from professional digital forms, a free boilerplate form, or find a local estate planning attorney to draft your living will. You may also want to see the advance directive forms.
These estate planning products, provided by Nolo, can help you quickly create estate planning documents that are legally valid in your state, customizable to suit your needs, professionally written, and regularly updated by expert attorneys. Use these to create a legal, enforceable living will and other documents.
Free Living Will Form
The form below is a very basic one, using boilerplate language, and is intended for educational purposes only. It has not been vetted by an expert, or updated. It may not be legally valid.
LIVING WILL DECLARATION
Declaration made this the _____ day of ____________, 20__.
I, _________________________, am at least eighteen (18) years of age and am of sound and disposing mind, willfully and voluntarily and do hereby make known my desires that my dying shall not be artificially prolonged under the circumstances set forth below.
I further declare:
If, at any time I have an incurable injury, disease or illness certified in writing to be a terminal condition by my attending physician, and my attending physician has determined that my death will occur within a short period of time, and the use of life-prolonging procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally with only the provision of appropriate nutrition and hydration and the administration of medication and the performance of any medical procedure necessary to provide me with comfort, care, or to alleviate pain.
In the absence of my ability to give directions regarding the use of life-prolonging procedures, it is my intention that my family and my physician(s) accept the consequences of the refusal honor this declaration as the final expression of my legal right to refuse medical or surgical treatment and.
I hereby state that I understand the full import of this declaration.
COUNTY OF )
STATE OF )
Subscribed and sworn before me this the _____ day of ____________, 20__.
Witness my hand and seal.
_____________________________________ My commission expires: