Indiana Living Will Form (Advance Directive)

Indiana Advance Health Care Directive is a document, drawn up with reference to § 16-36-4-8(b)(5)§ 16-36-1-7. An Indiana living will requires two witnesses and allows a patient, who is often called the `Principal`, to choose the medical treatment should they become too ill to do so themselves. The document is not legally binding should the principal become pregnant.

How to Write

Indiana Living Will Declaration

The principal must carefully read the document and then complete the relevant blank fields.


Principal`s Details

  • Date.
  • Principal`s name.


Artificial Provision Of Hydration & Nutrition

The principal must check the relevant box and then sign to express their wishes regarding provision artificially of hydration and nutrition.

  • Check box to receive artificial hydration and nutrition in any event.
  • Check box to not receive artificial hydration and nutrition if doing so is considered futile or burdensome.
  • Check box to give authority to a designated agent regarding provision of hydration and nutrition.
  • Enter principal`s signature.
  • Enter principal`s address.



The signatures of two witnesses and the date must be entered into the relevant blank fields.