New York Living Will Form

The New York living will is a legal document that will allow to an individual (principal) to address their medical choices, in the event the principal is no longer able to make their medical decisions. This document will provide specific instructions for their medical providers and health care agent, describing their final wishes, should they reach an end of life circumstance. The document must be completed while the principal is of sound mind and must be witnessed to be legally effective. Should the Principal wish, the document may be revoked at any time.


Laws – 29-C §2980 et seq.

How to Write

Step 1 – Introduction –

  • The principal must download the document and read the introduction on the first page of the document

Step 2 – Establish the Principal –

  • The Principal should first read the remainder of the document to ensure that there is a clear understanding.

Step 3 – Other –

  • If any of the statements are unacceptable to the Principal, strike through them and they will not be considered a part of the wishes of the Principal.

Step 4 – Enter the Principal’s name into the first line of the document

Step 6 – Additional Instructions –

  •  Should the Principal have additional instructions, enter them into section three (3). If more room is required add a sheet with the additional instructions and attach it to the form

Step 7 – Signatures and Witnesses – The witnesses must read and agree to the witness statement. Submit:

  • Each witness must enter their respective signatures
  • Date the signature in mm/dd/yyyy format
  • Complete addresses

Provide copies for each signatory, medical providers and any other interested parties