Fill in Living Will (Advance Medical Directive)

Fill in your details

Living Will (Advance Medical Directive)

Answer what you can. The draft beside these boxes is rewritten as you go, so you can see exactly what each answer does to the document.

What you type stays in this browser. Moving to a new step asks this site to draw it, but nothing is kept anywhere until you choose to keep a copy — and closing this tab loses it.

Your answers

Nothing answered yet. There are 4 questions on this form.

Still to answer

4 answers are still to come.

Nothing is amiss in what you have written. The document is simply not finished, and the draft marks each gap where an answer will go.

The live draft

The draft, as it stands

This is the document as far as you have reached, not the whole of it yet — the rest appears as you answer more questions. It is rewritten every time you change an answer.

A long blank line — __________ — stands wherever an answer has not been given. It is left that visible on purpose, so an unfinished document cannot be mistaken for a finished one.

No answer has been given, so every place a detail belongs is standing blank. The shape of the document is worth reading even now.

LIVING WILL (ADVANCE MEDICAL DIRECTIVE)

I, __________, son/daughter/wife of __________, aged __________ years, of __________, being an adult of sound mind, make this Living Will of my own free will, without pressure from anyone, at a time when I understand what I am writing.

1. WHEN THIS APPLIES

2. TREATMENT I REFUSE

5. WHO SPEAKS FOR ME

6. HOW I ASK THIS TO BE FOLLOWED

SIGNING

Executor: __________

Witness 1 (name, address, signature): ____________________
Witness 2 (name, address, signature): ____________________

Attested before me (Notary Public or Gazetted Officer, name, seal and date): ____________________

The rest stays out of view until every answer is in.

Reading costs nothing. Keeping a copy needs an account.

The opening of the draft is on this page as you answer it. Once every answer is in, the button below opens the whole draft, watermarked — still without an account. Printing it, or keeping a clean copy, is where an account is asked for. That is the whole arrangement.

A kept copy has to belong to somebody, and that is the reason for the account. There is nothing further to it.

Continue to download

Carry on reading without one

Back to what this document is