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Definitions – “Living will form” means a written statement in compliance with section § 19a-575a, containing a declarant’s wishes concerning any aspect of his or her health care, including the withholding or withdrawal of life support systems (§ 19a-570(9)).
Signing Requirements – Acknowledgment of two (2) witnesses is needed for proper enforceability(§ 19a-575a). The form is advised to be corroborated by a licensed notary (§ 19a-578).
Revocation – § 19a-579a
Other Versions
Yale New Haven Health Version (also available in Spanish/en Español)
Download: Adobe PDF
Additional Resources
- Connecticare – Advance Health Care Directives Handout
- Connecticut Attorney General – Your Rights to Make Health Care Decisions
- CTLawHelp – Living Wills and Advance Directives
- Hartford HealthCare – Advance Directives Pamphlet
- Hartford HealthCare – Living Will
- Network of Care Connecticut – Living Will
Related Forms (7)
- Advance Directive
- Designation of a Conservator
- DNR Order Form
- Document of Anatomical Gift
- Durable (Financial) Power of Attorney
- Medical Power of Attorney
- MOLST Form
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF, MS Word (.docx)
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF
Download: Adobe PDF
Medical Orders for Life Sustaining Treatment (MOLST) Form
Download: Adobe PDF
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