Arizona Living Will Form (Advance Directive)

The Arizona living will form (advance directive) is a legal document that will allow Principal the opportunity, while of clear mind, to choose what would be most reflective of their choices should they ever face a time when they would not be able to speak for themselves or express their own wishes. The document will also provide the opportunity for the Principal to choose a trusted health care representative to oversee their written instructions. This document will require at least one, non-related person of age or the witness of a notary public upon completion, so that it may be legally effective.

Laws – §§36-3201 to 36-3297

How to Write

Step 1 – Download the document and begin by reading the information at the top of the page

Step 2 – Section 1 – Principal’s Information – Enter the following:

  • Name
  • Complete address
  • Principal’s Age
  • Date of Birth
  • Telephone number

Step 3 – Section 2 – End of Life Health Care Decisions –

  • The Principal must apply their initials next to each statement that would best indicate their preferences to include 1.,2. and 3 under section B. If the Principal wishes to initial E, there is no reason to provide initials on the other lines.

Step 4 – Section 3 – Special Provisions –

  • The Principal must either place their initials or an “X” next to either A or B
  • If “B” is checked, then the Principal must attach and special instructions on a separate sheet titled “End of Life Care I Want”

Step 5 – Principal’s Signature Verification –

  • If the Principal is able to sign this form on their own, they must enter their signature
  • Date of signature in mm/dd/yyyy format
  • OR
  • If the Principal is unable to sign the document on their own, then a witness must carefully review the Witness Verification section and provide the following:
  • Witnesses printed name
  • Witnesses Signature
  • Date of Signature in mm/dd/yyyy format
  • Step 6 – Signature of Witness OR Notary Public – Enter the following information according to the Principal’s selection regarding how to witness the document:

Witness –

  • The witness must carefully review and agree to the witness paragraph and enter:
  • Witness’ Printed Name
  • Witness’ Signature
  • Date of signature in mm/dd/yyyy format
  • Witness’ complete physical address

Notary Public –

  • Should the Principal choose to have their document witnessed by a notary, the notary will need to be present for the signature of the Principal
  • The notary shall then complete the notary acknowledgement section of the document