Free Health Care Directive

Answer a few simple questions Print and download instantly It takes just 5 minutes

Create Your Free Health Care Directive

Answer a few simple questions
Email, download or print instantly
Just takes 5 minutes

Health Care Directive

Create Your Health Care Directive

What would you like to include in your Health Care Directive?
Most people include both

Appoint someone as my Health Care Surrogate

Specify my health care preferences

Both

Back Create My Document

Your Health Care Directive

Update Preview

This document preview is formatted to fit your mobile device. The formatting will change when printed or viewed on a desktop computer.

Page of

Living Will Directive

Directive of _________________________ dated ________ day of ________________, ________.

In this Living Will Directive I, _________________________, of ____________________________, ______________________________, Kentucky __________, being of sound mind, willingly and voluntarily express my wishes regarding life prolonging treatment, artificially provided nutrition and hydration and comfort care to be provided to me if I no longer have decisional capacity, and if I have a terminal condition, or become permanently unconscious.

DEFINITIONS
For the purposes of this document, the following definitions apply:

Health care decision means consenting to, or withdrawing consent for, any medical procedure, treatment or intervention.

Artificially provided nutrition and hydration means sustenance or fluids that are artificially or technologically administered.

Comfort Care means the performance of any medical procedure, including the administration of medication, deemed necessary to alleviate pain. Comfort care does not include artificially provided nutrition and hydration.

Life-prolonging treatment means any medical procedure, treatment or intervention which:

Utilizes mechanical or other artificial means to sustain, prolong, restore, or supplant a vital function; and
When administered to a patient would serve only to prolong the dying process. Life prolonging procedure does not include comfort care or artificially provided nutrition and hydration.

Permanently unconscious means a condition which, to a reasonable degree of medical probability, as determined by the patient's attending physician and one (1) other physician on clinical examination, is characterized by an absence of cerebral cortical functions indicative of consciousness or behavioral interaction with the environment.

Terminal condition means a condition cause by injury, disease, or illness which, to a reasonable degree of medical probability, as determined by the patient's attending physician and one (1) other physician, is incurable and irreversible and will result in death within a relatively short time, and where the application of life-prolonging treatment would serve only to artificially prolong the dying process.

DESIGNATION OF HEALTH CARE SURROGATE
I hereby designate and appoint _______________________ as my health care surrogate to make health care decisions for me in accordance with this directive when I no longer have decisional capacity. ____ initials

_______________________ resides at _______________________, _______________________, in the Commonwealth of Kentucky, __________ and can be reached at ______________________________.

I choose not to name an alternate health care surrogate.

POWERS AND AUTHORITY OF MY HEALTH CARE SURROGATE
Where used below, the phrase "Health Care Surrogate" refers both to my surrogate and to my alternate surrogate.

My Health Care Surrogate is authorized to act for me in all matters relating to my health care. I grant my Health Care Surrogate full power to give or refuse consent to all medical, surgical, hospital and related health care, according to my wishes as stated in this document or as otherwise expressed to my Health Care Surrogate. My Health Care Surrogate's powers include, but are not limited to, the authority to:

review and receive any information regarding my physical or mental health, including medical and hospital records, in accordance with the Health Insurance Portability and Accountability Act of 1996, 42 USC 1320d ("HIPAA");
sign any releases required in order to obtain such information;
sign any documents required to request, withdraw or refuse treatment, or to be released or transferred to another medical facility; and
make decisions on whether to provide, withhold or withdraw artificial nutrition and hydration.

My Health Care Surrogate does not have authority to act for me for any purpose other than the management of my health care. All of my Health Care Surrogate's actions under this power during any period when I am unable to make or communicate health care decisions have the same effect on my heirs, devisees and personal representatives as if I were competent and acting for myself.

Any prior designation is revoked.

DIRECTIVES
If at any time I have been clinically examined by two physicians, one of whom is my attending physician, and:

the two physicians certify that my condition is terminal and that, without the use of life-prolonging procedures, my death would likely occur within a reasonably short period of time; or
the two physicians certify that I am in a state of permanent unconsciousness;

and the application of life-prolonging procedures would serve only to prolong the dying process, I direct that I receive the following medical care:

If I am diagnosed as having a terminal condition: (initial all that apply)

_____ (initials) I DO NOT authorize the withholding or withdrawing of life-prolonging procedures;
_____ (initials) I direct that nutrition and hydration BE PROVIDED through any medically indicated means, including medically or surgically implanted tubes; and
_____ (initials) I direct that comfort care BE PROVIDED, even if it would have the effect of prolonging my life.

If I am diagnosed as being permanently unconscious: (initial all that apply)

_____ (initials) I DO NOT authorize the withholding or withdrawing of life-prolonging procedures;
_____ (initials) I direct that nutrition and hydration BE PROVIDED through any medically indicated means, including medically or surgically implanted tubes; and
_____ (initials) I direct that comfort care BE PROVIDED, even if it would have the effect of prolonging my life.

PREGNANCY
If I have been diagnosed as pregnant, and that diagnosis is known to my physician, this directive shall have no force or effect during the course of my pregnancy.

The remainder of this document will be available when you have purchased a license.

Question Help

Health Care Directive Document Preview

Document Preview About this Document

Last Updated April 14, 2025

Written by

Reviewed by

Fact checked by

When creating a document, LawDepot’s template gives you the following options:

Only specify your health care preferences
Only appoint someone to make medical decisions for you
Specify your health care preferences and appoint someone to make medical decisions for you

What is a Living Will?

A Living Will is a legally recognized document that outlines the specific medical care you wish to receive if you can no longer make medical decisions for yourself. It’s commonly requested by doctors and healthcare workers to understand what treatments to proceed with during medical emergencies and end-of-life care.

A Living Will is also known as a Health Care Directive. Some states use the terms Living Will and Health Care Directive interchangeably, while others use one term but not the other. The requirements for this document can also vary by jurisdiction.

Other common names for this document include:

Advance Directive
Advance Medical Directive
Advance Decision Form
Personal Directive

LawDepot's Living Will template automatically customizes your document to suit the laws in your selected state.

What is a Medical Power of Attorney?

A Medical Power of Attorney is a document that appoints someone to make medical decisions on your behalf. This person is known as your healthcare agent. Alternatively, your jurisdiction may call them a healthcare representative, surrogate, or attorney-in-fact.

An agent can use your Living Will to follow your wishes for treatment in medical emergencies if you’re no longer capable of making those decisions yourself. In addition to your directions in a Living Will, LawDepot’s template allows you to grant decision-making authority to another person through a Medical Power of Attorney.

A Medical Power of Attorney is also known as a Durable Power of Attorney for Health Care.

How does a Living Will work?

A Living Will goes into effect when you’re incapacitated or permanently unconscious, meaning you’re unable to make medical decisions for yourself.

If your medical practitioner, care home staff, or other medical personnel have a copy of your Living Will, they can look at what decisions you’ve made in your document for the care they can administer.

If you name a healthcare agent in a Medical Power of Attorney, they’ll work with medical teams to decide what treatment or intervention you’ll receive. If you’re incapacitated, your agent generally has the authority to:

Consent or refuse consent to treatments (per your Living Will)
Receive/review your medical and hospital records
Sign any medical releases or health care documents

It’s important to inform medical personnel of your Living Will or Medical Power of Attorney and include it with your medical record. For example, say you are going in for surgery, and during the procedure, you go into a coma due to complications. Your agent and doctors will know what you wish to have for care throughout the stages of recovery and can follow it without causing stress on your family.

Why do I need a Living Will or a Medical Power of Attorney?

Creating a Living Will and a Medical Power of Attorney is a key part of estate planning. It gives you control when you can’t speak for yourself and saves your family from making tough choices on your behalf.

Doctors will ask if you have a Living Will and a Medical Power of Attorney in certain situations, such as when you’re about to begin treatment or going in for surgery.

When creating a Medical Power of Attorney, you can discuss your medical choices and end-of-life care with your chosen agent. This will give them a better idea of why you’ve made the medical decisions you want them to follow.

If you don’t have any directives, it will come down to who healthcare professionals can legally ask to make decisions for you. For example, in Arizona, the people medical personnel defer to when you have no agent or guardian are your:

Spouse, unless you’re legally separated
Adult children
Parents
Domestic partner
Siblings
Close friend

If your family and friends don’t know your medical wishes, they’ll have to use their best instincts in making medical decisions for you. In stressful situations such as determining life-support, their choices may not be what you wish for yourself.

At what age should I make a Living Will?

Anyone who is at least the age of majority for their state and has the capacity to make a Living Will should do so.

It’s essential for any capable adult to be prepared for unexpected medical emergencies or if end-of-life care needs to take place.

Living Will versus Last Will

Your Living Will is a document that informs your healthcare providers of what kind of treatment you wish to receive in the specified medical situations. It is often called a Living Will because it is used while you’re still alive.

On the other hand, your Last Will and Testament documents how you wish your estate to be distributed when you pass away. It doesn’t leave instructions for medical care.

A Living Will and Medical Power of Attorney should also not be mistaken for an enduring or ordinary Power of Attorney. These documents name an agent to handle your day-to-day affairs like finances, business, and real estate should you become incapacitated or be absent for longer periods. It doesn’t include any details about medical care or grant an agent authority to make those decisions.

Additionally, you cannot provide instructions about your choice of funeral or burial in your Living Will. To outline your wishes for a final ceremony, obituary, and more, use LawDepot’s End-of-Life Plan.

Want a secure place for your essential estate planning documents? Save your Living Will, Last Will, and more in LawDepot’s Estate Vault.

How do I write a Living Will?

LawDepot’s customizable Living Will template lets you make a downloadable PDF to add or save to your estate plan. Follow our questionnaire with these easy steps:

1. Select what you want included in your Living Will

First, our template lets you decide what your document needs to include for your unique situation. The options include:

Appointing someone as your healthcare agent
Specifying your healthcare preferences
Both options combined

People typically choose both. This helps add your medical wishes and appoint an agent to create both a Living Will and Medical Power of Attorney. Your selection will then prompt you to include what’s next.

2. Add your details

Include your name, location, and contact details. Adding your location is a must, as each state has specific requirements for this document. For example, Alabama and Kentucky require a Living Will and a Power of Attorney to be combined in one document.

LawDepot’s template is customizable for each state to follow your jurisdiction requirements.

3. If desired, name your healthcare agent

Next, name someone as your healthcare agent if you wish to do so. This person will make the health care decision on your behalf and follow the instructions in your Living Will. Remember, the official title for your agent will vary by your jurisdiction.

You’ll need to add their name, location, and contact details. You may also need to specify their relationship to you.

4. Outline your healthcare choices

Include all the health care decisions you want in situations such as:

Becoming terminally ill
Ending up in a permanent coma
Ending up in a vegetative state

If you’re pregnant or could become pregnant, you can include how you wish your medical choices to be carried out if your state allows these instructions. You can also include more specific instructions if you have any relating to your health care. For example, you may not want a blood transfusion during a medical emergency due to personal or religious beliefs. You can note this in your document to inform medical staff of this request.

If you’re unsure if you need more instructions, talk to your doctor or a lawyer about what else you may need to put into your Living Will based on your unique circumstances.

5. Add your signing details

Finally, add the date you’ll be signing your document. If you don’t have one yet, leave it blank.

You must add the location where you’re signing your document as signing must take place in the state you’re living in and the document is for.

Who can be a healthcare agent?

Each state has its laws about who can be a healthcare agent. Generally, it must be someone who is at least 18 years old. The person you choose should also live nearby in case of an emergency. An agent must also be of sound mind and someone you trust to follow your wishes for medical care. Your healthcare professional (i.e., nurse, doctor, care home staff) should not be your agent.

It is important to talk to your possible agent. Communicating your wishes and putting them in writing can help them understand your decisions and ensure they are up for the task.

Can an agent override a Living Will?

Your agent and family generally cannot override your Living Will and Medical Power of Attorney if it’s valid. A Living Will is legally recognized, while a Medical Power of Attorney is legally binding.

There are a few instances where doctors can decide not to follow your Living Will. This includes if your instructions go against the institutes' policies or if they violate health care standards. However, a doctor can talk to you and your agent and refer you to another healthcare provider who will follow through with your decisions if they are unable to do so themselves.

In situations where your instructions are unclear, a doctor will do their best to respect your wishes. If a doctor takes medically acceptable measures that follow your instructions, they generally cannot be found liable for those actions under state legislation. Some states also restrict doctors and agents from using a Living Will during pregnancy.

Check your state laws for more details on your jurisdiction's restrictions.

State laws for Living Wills and Medical Powers of Attorney

Each state has different legislation and requirements for medical directives such as who can write one and when it may be restricted. Examples of these include the following:

State	Requirements & Restrictions
Alabama	You must be at least 19 years old and competent to create directives Must be signed in front of at least two witnesses A Living Will and Medical Power of Attorney must be in one document Treatment cannot be withheld or withdrawn if a patient is pregnant
Alaska	You must be at least 18 years old to write instructions for treatment or a durable power of attorney for health care Must be signed in front of at least two witnesses or a notary public Doctors cannot follow a Living Will to withhold or withdraw life saving treatment if a patient is pregnant and they believe the fetus can develop into a live birth.
Arizona	You must be at least 18 years old to create a Living Will or Health Care Power of Attorney Must be signed in front of at least one witness or a notary public You can state if you want life-sustaining treatmentt if you’re pregnant and it's possible for the fetus to develop to a live birth
Arkansas	You must be at least 18 years old or a married or emancipated minor of sound mind to make health care decisions or authorize an agent Must be signed in front of at least two witnesses or a notary public Doctors cannot withhold or withdraw life-sustaining treatmentl if a patient is pregnant and they believe the fetus can develop to term and birth
California	You must be at least 18 years old to execute a power of attorney for health care and give health care instructions Must be signed in front of at least two witnesses or a notary public
Colorado	You must be at least 18 years old with decision-making capacity can create instructions for healthcare Must be signed in front of a witness or a notary public
Connecticut	You must be at least 18 years old to create a document with healthcare directions Must be signed in front of at least two witnesses Allows you to include provisions for life support when pregnant
Delaware	You must be at least 18 years old and competent to give instructions for medical treatment and create a power of attorney for health care Must be signed in front of at least two witnesses Doctors cannot withhold or withdraw life-sustaining treatment if a patient is pregnant and they believe the fetus can develop into a live birth.
District of Columbia	Anyone who is at least 18 years of age can create healthcare instructions Must be signed in front of at least two witnesses
Florida	You must at least be 18 years of age and competent to create a health care advance directive Must be signed in front of at least two witnesses Unless otherwise specified in a directive, withholding or withdrawing life-prolonging procedures is not permissible on pregnant patients
Georgia	Must be at least 18 years old or be emancipated to document health care decisions and name an agent Must be signed in front of at least two witnesses Doctors cannot withhold or withdraw life-sustaining treatment if a patient is pregnant and the fetus is viable with the potential for a live birth
Hawaii	An adult or an emancipated minor can give instructions for health care or authorize an agent Must be signed in front of at least two witnesses or a notary public
Idaho	You must be at least 18 years old and competent to create an advance care planning document Your document must be notarized
Illinois	You must be at least 18 years old or be an emancipated minor to create instructions for health care Must be signed in front of at least two witnesses Doctors cannot execute a Living Will if a patient is pregnant and they believe the fetus can develop to a live birth
Indiana	You must be at least 18 years of age and of sound mind to create a Living Will Must be signed in front of at least two witnesses or a notary Living Wills cannot take effect if a patient is pregnant
Iowa	You must be at least 18 years of age and competent to create instructions for health care Must be signed in the presence of two witnesses or notarized
Kansas	You must be at least 18 years of age to make a declaration for health care Must be signed in front of at least two witnesses or a notary A Living Will has no effect during a patient’s pregnancy
Kentucky	You must be at least 18 years of age and of sound mind to create instructions for healthcare A Living Will and Medical Power of Attorney must be in one document Must be signed in front of at least two witnesses or a notary A Living Will has no effect during pregnancy unless procedures will be physically harmful to a patient, prolong the patient’s severe pain that cannot be alleviated through medication, or not allow the baby to be born
Louisiana	You must be at least 18 years old and of sound mind to create healthcare instructions in a declaration Must be signed in front of at least two witnesses Directives must be interpreted to preserve human life which includes not withdrawing from life-sustaining care if a pregnancy can be maintained until birth
Maine	You must be at least 18 years of age or an emancipated minor and have capacity to create instructions for health care and name an agent Must be signed in front of at least two witnesses
Maryland	You must be at least 18 years old and competent to create a directive Must be signed in front of at least two witnesses The state allows you to include instructions for if you become pregnant
Massachusetts	You must be at least 18 years old and competent to appoint a health care proxy Must be signed in front of at least two witnesses The state does not see a Living Will as a legally binding document, however, it can still help medical providers and the court make decisions on your behalf
Michigan	Michigan doesn’t have legislation governing Living Wills and are not considered legally binding It’s still good for a competent adult to create one to provide guidance to family and medical staff The state has legislation for creating a Durable Power of Attorney to appoint a patient advocate (a health care agent) to make medical treatment decisions for you. You must be 18 years old and of sound mind to appoint a patient advocate and it must be signed in front of at least two witnesses
Minnesota	You must be at least 18 years old with capacity to create a directive Must be signed in front of at least two witnesses or a notary Instructions for health care during pregnancy can be included
Mississippi	Must be at least 18 years old or be emancipated Must be signed in front of at least two witnesses or a notary
Missouri	You must be at least 18 years old and of sound mind to create a medical declaration Must be signed in front of at least two witnesses Treatment cannot be withheld or withdrawn if a patient is pregnant
Montana	You must be at least 18 years old and of sound mind to create a medical declaration Must be signed in front of at least two witnesses Life-sustaining treatment cannot be withheld or withdrawn if a patient is pregnant and they believe the fetus can develop into a live birth
Nebraska	You must be at least 19 years old or married with a sound mind to create a medical declaration Must be signed in front of at least two witnesses or a notary Life-sustaining treatment cannot be withheld or withdrawn if a patient is pregnant and they believe the fetus can develop into a live birth
Nevada	Must be at least 18 years old and of sound mind Must be signed in front of at least two witnesses Life-sustaining treatment cannot be withheld or withdrawn if a patient is pregnant and they believe the fetus can develop into a live birth
New Hampshire	Must be at least 18 years old and of sound mind to create a Living Will Must be signed in front of at least two witnesses Life-sustaining treatment cannot be withheld or withdrawn from a pregnant patient unless it is determined that the pregnancy is not viable
New Jersey	Must be at least 18 years old and of sound mind Must be signed in front of at least two witnesses or a notary The state allows pregnancy-specific instructions and instructions to limit an agent’s authority if the declarant is pregnant
New Mexico	Must be at least 18 years old or an emancipated minor with capacity Recommended sign in front of at least two witnesses or a notary
New York	There is no legislation for writing a Living Will, but laws determine the authority to appoint a healthcare agent
North Carolina	You must be at least 18 years old and of sound mind to create a Living Will or Advance Directive Must be signed in front of at least two witnesses and a notary
North Dakota	You must be at least 18 years old and of sound mind to create a health declaration Must be signed in front of at least two witnesses or a notary Treatment must be provided if a patient is pregnant unless the procedure will not maintain development and a possible birth or if it will be harmful to the patient
Ohio	You must be at least 18 years old and of sound mind to create a health declaration Must be signed in front of at least two witnesses or a notary Life-sustaining treatment cannot be withheld or withdrawn if a patient is pregnant and they believe the fetus can develop into a live birth
Oklahoma	You must be at least 18 years old and of sound mind to create a directive Must be signed in front of at least two witnesses You can specify the treatment you will receive if you are pregnant
Oregon	You must be at least 18 years old, married, or an emancipated minor with the capability to create an advance directive for health care Must be signed in front of at least two witnesses or a notary
Pennsylvania	Must be at least 18 years old or has graduated high school, is married, or emancipated and of sound mind Must be signed in front of at least two witnesses Treatment must be provided if a patient is pregnant unless the procedure will not maintain development for a possible birth or cannot be done because it will be harmful to the patient
Rhode Island	You must be 18 years or older and competent to create a declaration for healthcare A Living Will must be signed in front of at least two witnesses, whereas a Durable Power of Attorney for Health Care must be signed in front of two witnesses or a notary Doctors cannot follow a Living Will if a patient is pregnant and they believe the fetus can develop into a live birth
South Carolina	You must be 18 years or older and competent to create a declaration for healthcare Must be signed in front of at least two witnesses and a notary Living Wills cannot take effect if a patient is pregnant as they cannot withdraw from treatment.
South Dakota	You must be 18 years or older and competent Must be signed in front of at least two witnesses or a notary public Life-sustaining treatment must be provided to a pregnant patient unless the procedure will not maintain the development of the fetus or it will be harmful to the patient
Tennessee	You must be at least 18 years old or be emancipated to create an advance directive for health care Must be signed in front of at least two witnesses or a notary public
Texas	You must be at least 18 years old to create a directive Must be signed in front of at least two witnesses Life-sustaining care cannot be withdrawn or withheld from a pregnant patient
Utah	You must be at least 18 years old or an emancipated minor with the capacity to make healthcare decisions Must be signed in front of at least one witness Living Wills cannot take effect if a patient is pregnant
Vermont	You must be at least 18 years old to create an advance directive Must be signed in front of at least two witnesses Can register your document with the state Legislation permits you to include which treatments you would prefer if you become pregnant
Virginia	You must be at least 18 years old with capacity to create a directive Must be signed in front of at least two witnesses You can register your document with the Advance Health Care Planning Registry The state allows you to include directions if pregnant
Washington	You must be at least 18 years old with capacity to make health care decisions Must be signed in front of at least two witnesses or a notary Living Wills cannot take effect if a patient is pregnant
West Virginia	You must be at least 18 years old or be an emancipated minor and have capacity to make health decisions Must be signed in front of at least two witnesses and a notary
Wisconsin	Must be at least 18 years old and of sound mind to create a health declaration Must be signed in front of at least two witnesses Living Wills cannot take effect if a patient is pregnant
Wyoming	You must be at least 18 years old or an emancipated minor and have capacity to make health decisions Must be signed in front of at least two witnesses or a notary

If you want to know more about your state’s legislation or have questions about writing a Living Will, reach out to a lawyer.

Do I need a lawyer to make a Living Will?

Can I make changes to my Living Will?

Yes, you can make changes or revoke your Living Will and Medical Power of Attorney. Reasons you may need to update your document include:

Being diagnosed with a new illness
Change in marital status
Move to a different state
Change in choices for medical care

For example, say you get a divorce from your spouse. State legislation usually says that dissolving a marriage or legal separation revokes your spouse’s role as an agent. So you’ll need to ensure your document is up-to-date with a new agent of your choice.

If circumstances change you can create a new Living Will to revoke your original document. When you amend your document you will need to:

Give the new document and its copies to the appropriate people (e.g., doctor, nursing home, health care agent)
Discuss any changes in your health care preferences with your family, friends, and health care agent
Destroy outdated versions

Each state will have different requirements for updating or revoking your Living Will.

Does a Living Will need to be notarized?

Some states require a Living Will and a Medical Power of Attorney to be notarized or witnessed. Even if your state doesn't require it, you may wish to notarize your document to help ensure its validity. It can verify your identity when signing and further authenticate your document.

Each state will have requirements for who can be a witness. For example, in the state of Washington, a witness must be a legal adult but cannot:

Be related to you by blood or marriage
Stand to inherit from your estate
Be your attending physician or their employees, or the employees of a health facility in which you are a patient

Notarize your Living Will without meeting a notary in person by using LawDepot’s Online Notary. Our online notarization services for Living Wills are available in all states except Minnesota.

Free Health Care Directive

Create Your Free Health Care Directive

Health Care Directive

Create Your Health Care Directive

Create Your Health Care Directive

Your Health Care Directive

What is a Living Will?

What is a Medical Power of Attorney?

How does a Living Will work?

Why do I need a Living Will or a Medical Power of Attorney?

At what age should I make a Living Will?

Living Will versus Last Will

How do I write a Living Will?

1. Select what you want included in your Living Will

2. Add your details

3. If desired, name your healthcare agent

4. Outline your healthcare choices

5. Add your signing details

Who can be a healthcare agent?

Can an agent override a Living Will?

State laws for Living Wills and Medical Powers of Attorney

Do I need a lawyer to make a Living Will?

Can I make changes to my Living Will?

Does a Living Will need to be notarized?

Related documents

Related articles