New York Living Will Form

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The New York Living Will is a documented summary of one’s wishes concerning health care options should a situation arise when they can no longer communicate preference. The paperwork creates designations for a medical professional to use as a potential guide for navigating a course of treatment if the patient becomes incapacitated. Within the form are posed scenarios where the declarant can select their desired choices for an official record, should an unforeseen event occur. The principal can choose their requested elections regarding how to handle CPR, cardiac resuscitation, pain medication administration, and life-support.

Other Versions (6)

Compassion and Support New York Version (also available in Spanish/en Español)

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End of Life Choices New York Version

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Everplans Verison

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New York State Senate Version

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United Health Services New York Version

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University of Rochester Medical Center Verison

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Instructions: Adobe PDF

 

 

Additional Resources

Related Forms (5)

Advance Directive (Medical POA & Living Will)

Download: Adobe PDF

 

 

 


Advance Directive Wallet Card

Download: Adobe PDF

 

 

 


Durable (Financial) Power of Attorney

Download: Adobe PDF, MS Word (.docx)

 

 

 


Medical Orders for Life-Sustaining Treatment (MOLST)

Download: Adobe PDF
Instructions: Adobe PDF

 

 

 


Nonhospital Order Not to Resuscitate (DNR Order) (also available in Spanish/en Español)

Download: Adobe PDF