West Virginia Living Will Form (Advance Directive)

The West Virginia living will, or ‘advance directive’ is created with respect to §§16-30-1 to 16-30-25,  giving a person the right to legally dictate to medical staff the sort of care they will receive if they become ill so that they are no longer able to do this personally. These choices may be ones such as receiving life-sustaining treatments like insertion of feeding tubes and artificial respiration. A West Virginia living will form requires two witnesses and notarization per § 16-30-4(a).

How to Write

Living Will

The principal must enter their details.

  • Date.
  • Principal`s name.


Special Directives Or Limitations

The principal may enter any details of specific directives or limitations they might have regarding their medical health care.



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

  • Principal`s signature.
  • Principal`s address.
  • Witnesses signature.
  • Date.
  • Notary`s name.
  • Principal`s name.
  • Witnesses names.
  • Date.
  • Date.
  • Date of expiration of commission.