Rhode Island Living Will Form

The Rhode Island living will is a legal document (also known as an advance directive) that is used for the purpose of establishing the wishes of the Principal with regard to their selection of end of life medical care. The Rhode Island “living will” form, although brief, specifies the desire to withhold treatment in the event that the Principal will no longer have the ability to discuss medical care with their providers. The document will only require the signatures of two (2) witnesses of whom will have witnessed the Principal’s signature, to be legally effective. The document must be completed while the Principal is of sound mind. The form may be revoked at the Principal’s sound discretion.


Laws – 23-4.11-1, et seq. Rights of Terminally Ill Act

How to Write

Step 1 – Download the document- Begin by reviewing the first page – Proceed to the second page and submit:

  • The Principal’s full name into the first line of the paragraph
  • Read the remainder of the section

Step 2 – Authorization of withholding or withdrawal of feeding tube –

  • Check the appropriate box stating the inclusion of this action

Step 3 – Signatures –

Principal –

  • Enter the date of the Principal’s signature in dd/mm/yyyy format
  • Submit the Principal’s signature
  • Provide the Principal’s address

Witnesses – The witnesses must read the witness statement, enter:

  • Witnesses respective signatures
  • Witnesses respective addresses