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North Carolina Living Will Form

The North Carolina living will is a legal document that is designed to guide an individual (Principal) through the process of recording their end of life medical decisions so that their medical providers and health care professionals will be able to refer to the document while making decisions with regard to the steps to take at the end of the Principal’s life. The State laws will heavily protect the rights of a Principal to choose how they will die as naturally and comfortably as possible. The health care agent and medical professionals will be expected to honor the Principal’s decisions. This form may only be completed by the Principal and must be completed while the individual is of sound mind. This document will be implemented only when the Principal is no longer competent to make their own health care decisions.


Laws – 90-320, et seq. Right to Natural Death

How to Write

Step 1 – After the document has been downloaded, the Principal must read the introduction to the document at the top of the document.

Step 2 – Principal’ Desire for a Natural Death –

  • Enter the name of the Principal

Step 3 – When Directives Will Apply –

  • The Principal must read the statement and initial one or all of the choices in the box. The same instructions would apply to the following sections:
  • Directives Regarding Prolonging of Life
  • Exceptions – Artificial Nutrition or Hydration
  • Read – “I Wish to be Made as Comfortable as Possible ” and “I Understand my Advance Directive”
  • Available Health Care Agent
  • Read:
  • “My Health Care Providers May Rely on this Directive”
  • “I Want this Directive to be Effective Anywhere”
  • “I have the Right to Revoke this Direction” – If the Principal revoked the document, enter the date of revocation and signature, at that time

Step 4 – Witnesses and Notarization – Witnesses must read the statement carefully, if in agreement:

  • Date the witnesses signatures in mm/dd/yyyy format
  • Witnesses must enter their signatures (respectively)
  • AND
  • The Principal and the witnesses must again sign before a notary so that the document may be legally effective:
  • The notary shall then complete the remainder of the document and affix the official notary seal

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