Healthcare directive builder

Template only - not legal advice. Healthcare directive execution requirements (witnesses, notarization) and terminology vary by state. Have an estate planning attorney review this document, and give copies to your healthcare agent, primary doctor, and close family. See our full disclaimer.

1. Your information

Your full legal name

State of residence

Date prepared

2. Healthcare agent

Primary healthcare agent's full name

Relationship to you

Agent's phone number

Alternate agent's full name (if primary can't serve)

3. Life-sustaining treatment preferences

If I have a terminal condition with no reasonable expectation of recovery, life-sustaining treatment should be:

If I am permanently unconscious with no reasonable expectation of regaining awareness, life-sustaining treatment should be:

Artificial nutrition and hydration (feeding tube) in the above situations should be:

Pain management and comfort care preference

4. Additional wishes

Organ and tissue donation

Specific organ donation instructions

Additional personal wishes or instructions (optional)

Your advance healthcare directive

Get an estate planning attorney review

An estate planning attorney confirms your directive meets your state's exact execution and terminology requirements, since some states use specific statutory forms that hospitals are most familiar with.

What's the difference between a healthcare proxy and a living will?

A healthcare proxy (or healthcare power of attorney) names a specific person to make medical decisions on your behalf when you can't communicate them yourself - this person can respond to situations as they actually unfold, applying judgment to circumstances no document could fully anticipate in advance. A living will, by contrast, documents your specific treatment preferences directly (like whether you want life-sustaining treatment in specific scenarios), without necessarily naming a decision-maker.

Most modern estate planning combines both into a single "advance directive," as this builder does - naming an agent while also documenting specific preferences that guide that agent's decisions, giving you both a trusted decision-maker and clear guidance for how you'd want them to decide. Pair this with the power of attorney builder, which covers financial rather than medical decisions.

Why does documenting specific preferences matter if I'm naming an agent anyway?

Even with a trusted agent named, documenting your specific wishes provides critical guidance and can prevent painful disagreements among family members who may have different opinions about what you would have wanted. Your agent is legally bound to follow your documented wishes where you've expressed them, and to use their best judgment about your likely wishes where you haven't - specific documentation reduces the guesswork and potential for family conflict during an already difficult time.

Documented preferences can also protect your agent emotionally, giving them confidence that a difficult decision reflects your actual wishes rather than being entirely their own judgment call to carry alone.

What happens without any advance directive at all?

Without a named healthcare agent, most states have a default hierarchy of who can make medical decisions (typically spouse, then adult children, then parents, then siblings), but this can create genuine problems if family members disagree, if your default decision-maker isn't actually who you'd choose, or if you have no close family members who qualify under the default hierarchy. In more contentious situations, a court may need to appoint a guardian to make healthcare decisions - a costly, slow, and stressful process precisely when speed and clarity matter most. Our power of attorney builder and will and testament builder guide cover related estate planning documents.

Frequently asked questions

Yes, as long as you have legal capacity, you can revoke or update your healthcare directive at any time by executing a new one (which typically revokes the prior version) or by a clear written or verbal statement of revocation communicated to your healthcare providers. It's important to distribute updated copies to your healthcare agent, primary doctor, and any hospital or care facility where you're a patient, since an outdated copy on file somewhere could create confusion if it doesn't match your most current wishes.

No formal qualifications are required, but choose someone who you trust to advocate for your wishes even under emotional pressure, who is willing and likely able to be reasonably available if needed, and ideally someone who has discussed your values and preferences with you directly rather than just holding the title. Some people choose not to name their closest family member specifically because that person might be too emotionally overwhelmed to make difficult decisions - there's no universal right answer, only the person you believe would best represent your actual wishes under difficult circumstances.

Generally yes, properly executed advance directives are legally binding on healthcare providers, though a provider with a genuine moral or religious objection to specific instructions may be permitted to decline to personally comply, provided they support a transfer of your care to another provider willing to honor your wishes rather than simply ignoring the directive. Hospitals are generally required to ask about and document advance directives upon admission, and providing your hospital with a copy in advance (rather than only having one on file with your attorney) helps ensure it's actually available and followed when needed.

No, these are different documents serving different purposes. A DNR is a specific medical order (typically signed by a physician, sometimes based on your documented wishes) instructing medical personnel not to attempt CPR if your heart stops or you stop breathing - it's narrower and more immediately actionable in an emergency than a general advance directive. An advance directive is broader, addressing overall treatment preferences and naming a decision-maker, and can inform whether a DNR order is appropriate, but doesn't automatically function as one. If you specifically want a DNR order in place, discuss this directly with your physician in addition to completing your advance directive.

Give copies directly to your named healthcare agent and alternate agent, your primary care physician (to be included in your medical record), and any hospital or facility where you're regularly treated. Keep a copy somewhere easily accessible in your home (not locked in a safe deposit box, which may not be accessible quickly in an emergency), and consider carrying a card in your wallet noting that you have a directive and who to contact. Some states also maintain a voluntary registry where you can file your directive for easy retrieval by healthcare providers - check whether your state offers this option.