Massachusetts Living Will FormMassachusetts Living Will FormMassachusetts Living Will Form
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LIVING WILL: MASSACHUSETTS
A NOTE ABOUT THIS DOCUMENT
Massachusetts
is
one of three states
that do not recognize Living
Wills, so this
form will
not be legally valid.
However, a Living Will like
this
can still be
invaluable
in helping to
guide
your Health
Care

Proxy
or other
family members who may be responsible
for your care
decisions.
We have provided this form
as an example based on Living Will forms from
other states. You
may make changes to this form
or use any other form
to better express your health care
wishes.

PART 1: TREATMENT PREFERENCES
A. Statement of Goals and Values
Optional:
Form valid i left blank

I want to say something about my goals and values, and especially what’s most important to
me during the last part of my life:

B. Preference in Case of Terminal Condition
If you want
to state what
your preference is, initial one only If you do not want to state a preference
here, cross
through the