	New Jersey Advance Health Care Directive(Living Will) Form
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The New Jersey advance health care directive(living will) is a legal document that is made available to guide a person, in this case identified as a “Principal” through the process of creating a document that will advise both their medical providers as well as their health care agent as to their personal end of life medical treatment. If the Principal has not yet established a health care agent, they may do so by providing the agent’s information within this document. If the Principal should feel the need, they may certainly revoke the document at any time.

Laws – 26:2H-53, et seq. Advanced Directives for Health Care

How to Write

Step 1 – Download the document – Designate a Health Care Representative –

The Principal must read the paragraph at the top of the page. If in agreement, enter the following information
The Principal’s name
AND
The Health Care Agent’s name
Agent’s full home address and telephone number
Continue to review the remainder of the section

Step 2 – Alternate Representatives – If for any reason the first Agent is unable to serve, the Principal may provide up to, two (2) additional agent’s to serve consecutively if needed – Enter:

Alternates (respective) names
Addresses
City
State
Telephone Numbers

Step 3 – Specific Directions –

The Principal must read each statement and initial the statement that would best reflect the wishes of the Principal
Should the Principal have additional specific instruction enter them on the lines provided, add a sheet and attach, if needed

Step 4 – Signatures and Witnesses –