Printable blank North Carolina Living Will Form

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What is North Carolina Living Will Form?

North Carolina living will form is a form one needs to fill to stop prolonging one’s life under certain medical conditions. The conditions themselves and the necessary explanations are in the form itself. It’s a four-page form that requires no additional documents.

What I Need the North Carolina Living Form for

This form is used for a person who doesn’t want their life prolonged medically under certain provided conditions. The form contains the list of these conditions and some extras.
The main reasons one can mark as reasons to not prolongate life are the following:

  • Incurable or irreversible conditions leading to inevitable death soon
  • Unconsciousness that’s determined as irreversible
  • Advanced dementia or irreversible loss of cognitive abilities for other reasons

There may be other reasons that need to be filled manually, if you are into this business and aware of possible conditions. In this form you can also specify whether you want your health care providers to withhold the procedures under specified conditions or to decide themselves whether it’s necessary.

How to fill out North Carolina living will form?

Here are the instructions on how to fill out North Carolina living will form. You can fill it online and then save, or download a fillable North Carolina living will form, print the blank version, and fill it manually.

  1. Enter the county you live in.
  2. Specify medical conditions that you do not want your life being prolonged under.
  3. Select whether you want life prolonging procedures cut or leave it to health care providers to decide.
  4. Specify conditions under which you want to receive artificial nutrition, artificial hydration, or both. These conditions make exceptions from rules you specify on Page 1.
  5. Name your health agent.
  6. Select whether this will overrides the instructions your health agent may give your health care providers, or vice versa.
  7. Enter the date and sign the form on Page 4.

The form is available for free. You can download North Carolina living will form as a PDF file, print it, and then fill and sign.
According to the laws of North Carolina, this form needs to be also signed by two witnesses and then be notarized.

Organizations That Work with North Carolina Living Will Form

Health care providers

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