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STATE OF NORTH CAROLINA
ADVANCE DIRECTIVE FOR A
NATURAL DEATH (“LIVING WILL’)
COUNTY OF ________________
NOTE: YOU SHOULD USE THIS DOCUMENT TO GIVE YOUR HEALTH CARE PROVIDERS
INSTRUCTIONS TO WITHHOLD OR WITHDRAW LIFE-PROLONGING MEASURES IN CERTAIN
SITUATIONS. THERE IS NO LEGAL REQUIREMENT THAT ANYONE EXECUTE A LIVING WILL.
GENERAL INSTRUCTIONS: You can use this Advance Directive ("Living Will") form to give instructions for the
future if you want your health care providers to withhold or withdraw life-prolonging measures in certain
situations. You should talk to your doctor about what these terms mean. The Living Will states what choices you
would have made for yourself if you were able to communicate. Talk to your family members, friends, and others
you trust about your choices. Also, it is a good idea to talk with professionals such as your doctors, clergypersons,
and lawyers before you complete and sign this Living Will.
You do not have to use this form to give those instructions, b