Most people have strong preferences about their medical care, yet those decisions are often never put in writing. Having a documented record of your healthcare decisions brings clarity not only for you but also for those involved in your care. WordLayouts’ living will form template provides a structured starting point for documenting your healthcare preferences. It helps you define your medical choices through guided sections and simple checkboxes, so they can be understood and respected if you are ever unable to communicate them yourself.
Since many states have their own forms or legal requirements, review your state’s rules before completing or signing the document.
What Is a Living Will Form?
A living will form is a legal document that directs healthcare providers on a patient’s treatment preferences. It primarily outlines a person’s preferences related to end-of-life care. It means deciding about invasive life-sustaining procedures such as tube feeding, CPR, dialysis, artificial nutrition, and ventilation.
Any competent adult with the right mental capacity can create a living will to document their future healthcare preferences in case they become unable to communicate or make medical decisions. Without a living will, healthcare decisions may be made by a family member or another person authorized under your state’s laws if you are unable to make or communicate your own decisions.
Moreover, living wills are legally recognized in most U.S. states (not all); Massachusetts and Michigan have no living will statute, and requirements vary by state everywhere else. The National Institute on Aging’s guidance on advance directives and state-specific requirements is an important resource to understand the requirements and consequences of this document.
This document is also known as an Advance Directive, Health Care Directive, Advance Medical Directive, Advance Decision Form, and Personal Directive.
How to Fill Out This Living Will Form Template
Before completing this living will form, make sure you are using a version that is legally recognized in your state, as requirements can vary. If you are downloading the template online, obtain it from a trusted and secure source. Once you have the correct form, follow the steps below to complete it.
Step 1: Add your information
Start by adding your state name in the top left corner of the template. After that, in the principal section, write down your name, mailing address, and last four digits of your Social Security number (SSN).
This section states that the person creating the Living Will has reached the legal age of 18. It also confirms that the decision is being made with a sound mind and without any duress, fraud, or undue influence.
It also adds that this document will serve as clear and convincing evidence of the patient’s wishes for physicians, healthcare providers, and persons responsible for their medical care to honor and follow their wishes in case of inability to make or communicate their own healthcare decisions.
Step 2: Make life support decisions
The section lets you define your life support decisions. Through this section, you can define what an unacceptable quality of life means to you and decide what the doctors should do in such situations.
If your doctors determine that your condition is irreversible and your quality of life becomes unacceptable according to your stated preferences, you can choose whether you want life-prolonging treatments to be continued for as long as possible or withdrawn. The template provides checkboxes so you can select the option that best reflects your wishes.
To help define what an unacceptable quality of life means, the section includes several common circumstances you may wish to consider, such as:
- Continuous unconsciousness or persistent vegetative state
- Loss of ability to communicate my needs or preferences
- Loss of ability to recognize or meaningfully interact with family or friends
- Complete dependence on others for all basic care and daily living activities
- Other: __________________________________________________________
You can select checkboxes or define in “other option” what your definition of unacceptable quality of life is.
The last part also allows you to state your preferences regarding artificial nutrition and hydration.
You can choose whether you would want to receive food and fluids through a feeding tube or intravenous (IV) fluids under the circumstances described above, ensuring your healthcare decisions reflect your personal wishes.
Step 3: Specify life-sustaining treatments
Next, you can specify the life-sustaining treatments you do not wish to receive even in situations where recovery may still be possible.
The template provides a list of common treatments, each with a checkbox and space for your initials. You can check and initial the medical treatment options you do not want to receive.
The treatments listed include:
- Cardiopulmonary resuscitation (CPR)
- Ventilation
- Surgery
- Antibiotics
- Kidney dialysis
- Chemotherapy
- Blood products
- Invasive diagnostic tests
- Artificial nutrition (feeding tube)
- Artificial hydration (IV fluids)
- Other(s) (use this option to specify any treatment that’s not listed in the options mentioned above)
If you are unsure about this section and don’t want to make any selections, then leave it blank and draw a line through this entire section.
Step 4: Write down end-of-life wishes
This section gives you the flexibility to write down your end-of-life medical care wishes without any checkboxes or choices. The template leaves blanks to make it easier for the user to specify the kind of medical care, comfort, and support you wish to receive. For example, if you want to receive care focused on comfort and pain relief rather than aggressive treatment, specify here.
Step 5: Pain relief and comfort care
This part focuses on providing pain treatment and comfort care. This section reflects that your top priority is to receive proper pain management treatment while maintaining comfort and dignity at all times. It also states that you are willing to consider supportive care choices such as medicine, palliative care, or hospice services if recommended by your healthcare providers.
Step 6: Pregnancy care (if applicable)
According to this section, the living will’s direction regarding life-sustaining treatments may not be followed as written in case of special circumstances like pregnancy.
The template clarifies that certain state laws compel the continuation of life-sustaining treatment during pregnancy even if the document indicates otherwise. As a result, healthcare providers are legally obligated to obey these laws.
Pregnancy & living will
Living Will laws treat pregnancy differently in many US states. Some states have enacted pregnancy-related exceptions that limit the enforcement of a Living Will during pregnancy, often based on laws intended to protect a developing fetus. As a result, depending on the state, healthcare providers may be required to continue certain life-sustaining treatments despite the instructions in a Living Will.
Some states have special rules that may affect how a Living Will is applied during pregnancy. In certain states, a Living Will may be limited, suspended, or subject to additional requirements if a person is pregnant.
Because these laws vary by state and may change over time, it is important to review your state’s current requirements and discuss your wishes with a healthcare representative or legal professional.
Step 7: Effect of stated preferences
This part explains how your stated preferences in the Living Will should be interpreted and applied. The template allows you to decide how strongly you want your Will to be followed in unpredictable medical situations through these two options:
- Stated preferences are general guidance. Healthcare providers and decision-makers may exercise reasonable judgment to act in your best interests.
- Healthcare providers should follow the stated preferences exactly as written, even if an alternative course of action is considered preferable.
Each option includes a checkbox and space for your initials. You should select and initial the option that best suits your preference.
Step 8: Signature
Here, you finalize the document by signing it and adding the date in the relevant spaces. It is a confirmation that the patient has voluntarily completed the Will with full understanding of the purpose and implications.
Moreover, signing it will also replace any prior Living Will or similar directive that you may have made.
Witness Statement
Some states require a living will to be signed in the presence of one or more qualified witnesses, while others have different witnessing requirements. Since these rules vary by state, we have included a separate witness statement page with the template for users who need it.
This section is completed by the witness and needs to be filled out only if your state requires it. It helps states verify the authenticity of the document and the patient’s sound mind at the time of signing.
Through this section, the witnesses confirm the identification of the patient and the voluntary nature of the document. It also ensures that the signing took place in the presence of the witness.
Moreover, the witness also declares that they are not related to the principal and are not appointed as a decision-maker on behalf of the principal. The statement also confirms that the witnesses are not beneficiaries of the principal’s estate and are not directly involved in providing health care to the principal.
The template provides space for the witness to sign the document and enter the date and address.
Notary Acknowledgment
Notarization is not required for every living will, but some states require or permit notarization instead of witnesses or in addition to them. For convenience, our template also includes a separate notary acknowledgment page that can be used where applicable.
This section is completed by a notary public, which is why the template leaves blanks for the city, state, date, and the principal’s name. The purpose is to confirm that the principal understands the contents and legal effect of the living will at the time of signing.
Lastly, the notary will write down their name, signature, and commission expiry date and affix their official notarial seal.
Are Living Will, Last Will, and Living Trust the Same?
No, a living will, a last will, and a living trust are all different documents and serve different roles. A Living Will focuses on medical decision-making and takes effect during a person’s life, while a Last Will takes effect after a person’s death. It doesn’t involve any medical decision-making and outlines how financial and personal matters of a deceased person are handled according to their instructions.
Lastly, a Living Trust is used for managing assets during your lifetime and transferring them after death. One can place property, accounts, or investments into the trust and specify how they should be handled.
By understanding the distinct roles of a Living Will, Last Will, and Living Trust, you can create a plan that reflects your wishes and provides clear guidance for your loved ones when they need it most.
Do You Need a Lawyer to Finalize a Living Will?
No, legally, you don’t need a lawyer to make a living will. You can create it on your own after discussing it with your physician. You can either download state-specific forms or use an online template like this one to get started.
Can I Revoke or Change My Living Will?
Yes, you can revoke or change your Living Will at any time. Updates are often necessary after major life changes, such as a new medical diagnosis, divorce, relocation, or a change in treatment preferences.
To update your Living Will, make a new Living Will, distribute copies to your physician and others involved, talk about the changes with your family and healthcare agent, and discard any outdated versions. Requirements for revocation or modification vary by state, so it is important to follow your state’s legal guidelines.
Final Thoughts
A Living Will is a practical way to make sure that your medical preferences are clearly documented and respected when you are unable to communicate. Whether you’re living with a chronic illness, planning for the future, or simply want to be prepared, a living will gives you the opportunity to document your healthcare wishes in advance.
By recording your healthcare preferences in advance, you can reduce uncertainty during difficult moments and help ensure that your wishes remain at the center of every decision. This Living Will template is intended to provide a clear, customizable starting point for documenting those important choices with care and confidence.
