Living Will Form

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Planning for the unexpected includes making sure your healthcare preferences are known in advance. A Living Will expresses your choices about life-sustaining treatment, end-of-life care, and other medical decisions when you're not able to voice them. It ensures your values and wishes guide the decisions made by doctors and loved ones. Loio offers a straightforward way to create this essential document so you're prepared, no matter what the future holds.
LIVING WILL

Principal's name:  

Address:  

Date of birth:  

Social security number:  

Date of execution:  

 

This Living Will (the "Will") shall be used when you can no longer provide your healthcare wishes to your doctors or other medical personnel.

 

This Will consists of:

  • A Health Care Directive – a document that specifies your preferences for end-of-life treatment for medical personnel.
HEALTH CARE DIRECTIVE

 

I,  , an individual having my usual place of living at   and a social security number   (the "Principal"), desire to advise my doctors and/or medical personnel of my wishes for my health care in the event I no longer have decisional capacity.

 

LIFE SUPPORT TREATMENT

 

I desire that my doctor make a concerted effort to return me to an acceptable quality of life using the 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not improve; namely, my health condition is irreversible, I direct that all treatments that extend my life shall be withdrawn.

 

Unacceptable quality of life means:

 

CERTAIN LIFE-SUSTAINING TREATMENT

 

I do not wish to have these life-sustaining treatments under any circumstances, even if recovery is a possibility:

 

END-OF-LIFE WISHES

 

When I am near death, I wish to  .

 

ORGAN AND/OR TISSUE DONATION

 

Upon my death, I wish to make the following anatomical gift for purposes of transplantation, research, and/or education:

  • Any organ/tissue.

OTHER ISSUES

 .

GOVERNING LAW. This Living Will shall be governed by the laws of the State of  .

The Principal's name and signature 

 

______________________________________

 

WITNESS ACKNOWLEDGMENT

Witness 1

Signature: __________________________

Name:  

Address:  

Phone number:  

 

Witness 2

Signature: __________________________

Name:  

Address:  

Phone number:  

NOTARY ACKNOWLEDGMENT

 

State of  

Acting in the county of  

 

 

 

Sworn to and subscribed before me on ___________________________.

 

 

 

___________________________________

Place for signature

 

 

 

______________________________________

Notary public's name and seal

Written by Megan Thompson - Reviewed by Jonathan McGill

Template Description

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Paper titled "Living Will", woman and man shaking hands by the desk

A living will carries significant importance for people. This legal paper represents careful planning and consideration — it reflects an individual's healthcare choices in situations where they cannot articulate them personally. A living will form — PDF represents a person's independence and helps maintain their ability to make important health care choices. 

When Is a Living Will Used?

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A living will template is used in situations where a person is incapacitated and cannot voice their medical treatment preferences. Some common circumstances include:

  • Severe brain injury — If a person is in a coma or vegetative state with no reasonable chance of recovery, a living will forms to print guides the medical team and family on treatment preferences.
  • Terminal illness — Someone diagnosed with a disease in its final stages may want to avoid unnecessary interventions that prolong suffering.
  • Advanced dementia — If a person can no longer make informed decisions due to cognitive decline, their living will template can ensure their wishes are honored.
  • Major surgical complications — In cases where unplanned medical complications render a patient unable to communicate, a printable living will form may direct healthcare providers on the next steps.

How To Fill Out a Living Will: Step-by-Step

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Follow these steps to complete a printable living will and ensure your wishes are clearly documented.

Step 1: Provide your personal information

Begin by filling out the basic details that identify you as the Principal of the living will forms.

Part of the living will template free
  • Enter your full name where indicated.
  • Write your full current address to confirm your identity.
  • Provide your date of birth for official documentation.
  • List your Social Security number.
  • Specify the execution date, which is the date you sign the living will form PDF.
Example:

Principal's Name: Sarah Johnson
Address: 452 Maple Avenue, Denver, CO
Date of Birth: June 10, 1978
Social Security Number: XXX-XX-6789
Date of Execution: April 5, 2024

Step 2: Declare your healthcare directive

This section of living wills allows you to express your wishes regarding future medical care should you become unable to communicate.

Part of the free living will form to print
  • Restate your name and address to ensure clarity.
  • Authorize your doctors to follow the instructions listed in your living will template.
  • Decide on specific treatments you would like or refuse, such as artificial respiration, hydration, or feeding tubes.
Example:

I, Sarah Johnson, an individual having my usual place of living at 452 Maple Avenue, Denver, CO, and a Social Security number XXX-XX-6789 (the "Principal"), desire to advise my doctors and/or medical personnel of my wishes for my healthcare in the event I no longer have decisional capacity.

Step 3: Specify your end-of-life wishes

This section of the living will form allows you to indicate whether you want life-sustaining treatments or comfort care.

Part of the printable living will form
  • State your preferences about resuscitation, ventilation, and artificial life support.
  • Be specific if you wish to receive only palliative care.
Example:

When I am near death, I wish to receive only palliative care and forego life-prolonging treatments.

Step 4: Indicate the governing law

Each state has its own legal requirements regarding living will forms printable. Choosing the state law that applies ensures your document will be recognized.

Part of the living will form pdf
  • Choose the state governing your living will form to print.
Example:

This Living Will shall be governed by the laws of the State of Colorado.

Step 5: Sign the living will and include witness signatures

A living will PDF isn’t valid until it is signed by the Principal (you) and at least one witness.

Part of the free living will forms to print
  • Sign and print your full name.
  • Have a witness sign in the appropriate space.
  • Check if notarization is required in your state.
Example:

The Principal's Name and Signature

Full Name: Sarah Johnson

Witness Acknowledgment
Witness 1

Name: David Reynolds

Address: 300 Pine Street, Dallas, TX

Phone number: (555) 987-6543

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