Living Will - North Carolina

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North Carolina · Fillable PDF · Free

This is North Carolina’s official statutory living will. It tells your health care providers when to withhold or withdraw life-prolonging measures if you cannot make or communicate decisions. This is North Carolina’s official statutory living will. It tells your health care providers when to withhold or withdraw life-prolonging measures if you cannot make or communicate decisions.

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Who this form is for

This is North Carolina’s official statutory living will. It tells your health care providers when to withhold or withdraw life-prolonging measures if you cannot make or communicate decisions.

What you'll need

Read the packet and check the receiving agency's required form.
Gather the names, dates and supporting records requested in the document.
Review the packet's signing, identification and witness instructions.

How to complete it

Initial your choices (Pages 2–3) Initial when your directives apply, whether providers “may” or “shall” withhold measures, any nutrition or hydration exceptions, and whether your health care agent can override this directive.
Sign with two witnesses AND a notary (Pages 4–5) North Carolina requires two qualified witnesses and a notary, all present when you sign. We can provide qualified witnesses for an additional fee.
Give a copy to your doctor and a trusted relative.
Consider filing it with the North Carolina Advance Health Care Directive Registry.

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