West Virginia Living Will Form

The West Virginia living will is a legal document that will state clearly, the information that the person (testator) would like to convey to their physicians so that the physicians will know how to act with regard to their end of life choices for treatment. The document is a very brief and direct document containing the information needed in the event the testator is no longer able to communicate their wishes. This document will require the signatures of two (2) unrelated witnesses, who in turn, must be witnessed by a notary public. The testator, as long as they are of sound mind, may revoke this document at any time.


Laws – West Virginia Code 16-30-1, et seq.: West Virginia Health Care Decisions Act

How to Write

Step 1 – The testator must download the document – enter:

  • Enter the date of execution of the document in dd/mm/yyyy
  • Enter the name of the Principal
  • The Principal must carefully review the 3 paragraphs remaining
  • If the Principal would like to include instructions or refuse anything specific, enter the information into the lines provided

Step 2 – Signatures and Notarization –

  • The Principal must read the statement
  • If in agreement, submit the Principal’s signature
  • Enter their complete address

Witnesses – The witnesses must read the entire witness statement. If in agreement and before a notary public and one another, submit:

  • Witnesses must provide their respective signatures
  • Date signatures in mm/dd/yyyy format

Notarization – Once the Notary has witnessed and recorded all signatures the notary will complete the remainder of the notary section of the document, acknowledging the document. They shall then affix their seal or stamp

  • Once notarized, make copies for all signatories and any other interested parties that the testator would like to provide copies.