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North Carolina Living Will (Advance Directive)

The North Carolina living will, or ‘Advance Directive’ form is designed to allow patients to legally decide upon the medical health care treatment they can receive should they become so ill that they are unable to make these choices. These illnesses may be a coma or permanent unconsciousness for example. This document requires attestation by two (2) witnesses and a notary public in accordance with § 90-321, § 32A-16(3).

How to Write

Advanced Directive For A Natural Death

The principal must enter their name.

 

When Directives Apply

The principal must initial to denote the specific directives regarding prolonging of life they wish to apply to their health care.

  • In the event of an incurable or irreversible condition with a relatively short life expectancy.
  • In the event of unconsciousness with little chance of regaining consciousness.
  • In the event of severely impaired mental cognitive ability with little chance of recover.

 

Directives Regarding Prolonging Life

2) The principal must initial one field to denote their wishes regarding prolonging of life.

  • MAY withhold or withdraw life prolonging measures.
  • SHALL withhold or withdraw life prolonging measures.

 

Artificial Hydration And Nutrition

3) The principal must initial the relevant fields regarding artificial hydration and nutrition.

  • Initial to receive artificial hydration and nutrition.
  • Initial to receive only artificial hydration.
  • Initial to receive only artificial nutrition.

 

Availability Of Health Care Agent

6) If the principal has an appointed health care agent then the principal must initial the correct field to denote where the power over their medical health care rests.

  • Initial for `Advanced Directive` to ultimately have power.
  • Initial for `Agent` to ultimately have power.

 

Signatures

The principal, the witnesses and the notary must enter their details.

  • Date.
  • Principal`s signature.
  • Principal`s name.
  • Principal`s name.
  • Date.
  • Witnesses names.
  • County.
  • State.
  • Principal`s name.
  • Witnesses names.
  • Signature of notary.
  • Name of notary.
  • Date of expiration of commission.