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Living Will Declaration

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DECLARATION AS TO MEDICAL
OR SURGICAL TREATMENT
(CRS 15-18-104.)

I, , being of sound mind and at least eighteen years of age, direct that my life shall not be artificially prolonged under the circumstances set forth below and hereby declare that:

1. If at any time my attending physician advanced practice nurse and one other qualified physician or advanced practice nurse certify in writing that:

a. I have an injury, disease, or illness which is not curable or reversible and which, in their judgment, is a terminal condition, and

b. For a period of seven consecutive days or more, I have been unconscious, comatose, or otherwise incompetent so as to be unable to make or communicate responsible decisions concerning my person, then I direct that, in accordance with Colorado law, life-sustaining procedures shall be withdrawn and withheld pursuant to the terms of this declaration, it being understood that life-sustaining procedures shall not include any medical procedure or intervention for nourishment considered necessary by the attending physician to provide comfort or alleviate pain. However, I may specifically direct, in accordance with Colorado law, that artificial nourishment be withdrawn or withheld pursuant to the terms of this declaration.

2. In the event that the only procedure I am being provided is artificial nourishment, I direct that one of the following actions be taken:

a. Artificial nourishment shall not be continued when it is the only procedure being provided; or

b. Artificial nourishment shall be continued for days when it is the only procedure being provided; or

c. Artificial nourishment shall be continued when it is the only procedure being provided.

(Optional) I hereby make an anatomical gift, to be effective upon my death, of:

A. Any needed organs/tissues

B. The following organs/tissues:

Donor signature:

3. I execute this declaration, as my free and voluntary act, this

Declarant

The foregoing instrument was signed and declared by to be his/her declaration, in the presence of us, who, in his/her presence, in the presence of each other, and at his/her request, have signed our names below as witnesses, and we declare that, at the time of the execution of this instrument, the declarant, according to our best knowledge and belief, was of sound mind and under no constraint or undue influence.

We further declare that neither of us is : 1) a physician; 2) the declarant's physician or an employee of his/her physician; 3)an employee or a patient of the health care facility in which the declarant is a patient; or 4) a beneficiary or creditor of the estate of the declarant.

Dated at, Colorado, this

Name

Address

Name

Address

OPTIONAL

STATE OF COLORADO )

County of ) ss.

)

SUBSCRIBED and sworn to before me by the declarant, and

witnesses, as the voluntary act and

deed of the declarant this

My commission expires:

Notary Public

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What a Living Will Declaration Is

Living Will Declaration is a written advance directive that communicates an individual's preferences about life-sustaining medical treatment if they become incapacitated and unable to express informed consent. It typically specifies which treatments to accept or refuse, such as mechanical ventilation, tube feeding, cardiopulmonary resuscitation, and antibiotic use, and may appoint an agent or healthcare proxy for related decisions. The document serves as guidance for healthcare providers and family members and can reduce uncertainty during emergencies. Legal recognition varies by state; execute it according to applicable statutory formalities to ensure enforceability.

Why a Living Will Declaration Matters

A Living Will Declaration ensures your preferences for life-sustaining care are documented and available when you cannot communicate. It reduces family conflict, guides clinicians, and complements a durable power of attorney for health care. Proper execution increases legal enforceability across care settings.

Why a Living Will Declaration Matters

Who Typically Completes a Living Will Declaration

Adults making advance healthcare decisions, family members, and appointed healthcare agents commonly use a Living Will Declaration to record treatment preferences.

  • Adults with chronic illness or advanced age documenting treatment limits and resuscitation preferences.
  • Caregivers and family members seeking clear guidance for urgent medical decisions.
  • Individuals appointing a healthcare proxy and clarifying life-sustaining treatment choices.

Core Sections to Include in the Declaration

Core sections of a Living Will Declaration define preferences, specify treatments, name decision agents, and state execution and witness details.

Treatment Choices

Specify which life-sustaining interventions you accept or decline, for example mechanical ventilation, artificial nutrition, dialysis, CPR, antibiotics; include conditional preferences tied to prognosis or recovery likelihood.

Healthcare Proxy

Name a primary healthcare agent and alternates, include contact information, and clearly state the agent’s authority to accept or refuse medical treatment when you lack decision-making capacity.

End-of-Life Timing

Define triggering conditions such as terminal illness, irreversible coma, or permanent unconsciousness; clarify whether comfort care and palliative measures are always permitted and list exceptions.

Organ Donation

Indicate organ and tissue donation preferences, whether donation is permitted only after death, and any restrictions or additional authorizations you require for donation or transplantation.

Witnessing

Provide signature, date, and spaces for required witness(s) and notary acknowledgment per your state’s rules; consider adding a self-proving affidavit if available to simplify probate.

Revocation

Describe how to revoke or amend the declaration, such as destroying the document, signing a revocation statement, or executing a new directive; indicate effective date for changes.

Step-by-Step: Prepare and Execute the Declaration

Follow this sequence to prepare and execute a Living Will Declaration that meets legal and clinical needs.

  • 01
    Draft Preferences: List treatments you accept or refuse.
  • 02
    Choose Agent: Name primary and alternate healthcare agents.
  • 03
    Witness & Notary: Obtain required signatures per state rules.
  • 04
    Distribute Copies: Share originals with providers and agent.

How Electronic Execution Works

This online signing workflow outlines how a Living Will Declaration moves from creation to authenticated execution and distribution.

  • Upload Document: Sender uploads the Living Will form.
  • Place Fields: Add signature, date, and witness fields.
  • Authenticate Signer: Choose email, SMS, or stronger ID verification.
  • Complete Signing: Signers execute and receive certified copies.

Configure Online Workflow Settings

Configure online workflow settings to enforce witness rules, authentication strength, and document retention policies automatically.

Field Configuration
Authentication Level Email, SMS, or ID verification
Witness Enforcement Require witness fields before completion
Notary Integration Enable RON or in-person notarization
Retention Policy Define retention period and export format

Platform Features to Confirm

Ensure the eSignature platform supports required authentication, witness workflows, and secure storage for Living Will Declarations.

  • Formats: PDF, DOCX, and fillable forms
  • Integrations: Connects with EHR, cloud storage, CRM
  • Security: TLS 1.2/1.3 and AES-256 encryption

Essential Information to Include

Full Legal Name: Enter exactly as on government ID
Date of Birth: Enter as MM/DD/YYYY, no abbreviations
Address: Include street, city, state, ZIP
Treatment Preferences: List accepted or refused interventions
Healthcare Agent: Name primary and alternate agents
Signature Date: Signer must date using MM/DD/YYYY

Common Preparation Pitfalls

  • Using informal language or vague terms that fail to specify treatments, timing, or conditions, which can cause confusion for providers and families.
  • Signing without required witnesses or notarization under state law, leading to possible rejection during hospital review or probate proceedings.
  • Failing to update the declaration after major life events such as divorce, relocation, diagnosis changes, or new medical prognoses.
  • Providing mismatched names or incomplete contact details for agents, which can invalidate proxy authority and impede urgent communications.

Consequences of an Incorrect Declaration

Invalid Execution: Document may be unenforceable
Conflicting Instructions: Family disputes and litigation
Unwanted Treatment: Providers may administer full care
Medical Delay: Uncertainty can delay decisions
Guardianship Risk: Court-appointed guardian possible
Tax/Legal Fees: Attorney or probate expenses

Timing and Execution Considerations

Filing and execution timing varies by state; follow local statutory rules for witness, notarization, and record retention.

No Federal Filing Deadline:

No central filing requirement; keep copies available

Witness Timing:

Sign in presence of witnesses per state law

Notary Timing:

Notarize if state requires at signing

Update After Events:

Review after diagnosis, relocation, or divorce

Record Copies:

Provide copies to agent, providers, and family

eSignature Pricing and Feature Comparison

Compare typical eSignature plan characteristics relevant to executing Living Will Declarations, with signNow presented first for feature parity context.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial, no credit card Trial available Trial available Trial available Trial available
Bulk Send Yes (premium) Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes (BAA) Yes (BAA) Yes (BAA) No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Frequently Asked Questions About Living Will Declarations

Answers to common questions about completing, signing, and updating a Living Will Declaration, including legal and technical considerations.


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