Free New York Living Will Form

A New York living will is a written document that lets a competent adult name a health care agent and give end-of-life care instructions.[1] It is often prepared alongside a Medical Power of Attorney.

Last Updated: September 2026. This guide is reviewed and updated regularly to reflect current New York law. If you notice an error or outdated information, please contact us.

New York living will form preview

Create a free high quality New York Living Will online now!

Build Your Document

Answer a few simple questions to make your document in minutes

Save and Print

Save progress and finish on any device, download and print anytime

Sign and Use

Your valid, lawyer-approved document is ready

... or download your New York Living Will Form as a  PDF file or   Word file

New York law keeps a health care proxy and a power of attorney as separate documents. It does not allow you to execute both on the same form.[1] The document lets you decide in advance how life-sustaining treatment, pain relief, and organ donation should be handled if you become unable to speak for yourself.

As long as it is clear and convincing, health care providers will honor it. We recommend you consult an attorney, and talk with your family and the people you trust, to make sure the document is ready for whatever may come.

A New York living will can be part of, or paired with, other documents that cover similar ground:

  • A New York Health Care Proxy lets you name an agent you trust to make medical decisions for you. Filling out this part is optional when you create a living will.
  • An Advance Health Care Directive is a more detailed form that combines treatment instructions with the authorization of an agent.
  • A New York Power of Attorney is a separate legal form that authorizes someone to handle financial and property matters on your behalf.

Signing Requirements and Laws

Only a competent adult can create a New York living will and appoint a health care agent.[1] A New York Health Care Proxy form is optional, but we recommend appointing someone you trust to speak on your behalf if you cannot.

A living will and a Health Care Proxy work together. The proxy names your agent, and the living will spells out what you want that agent, your medical team, and your family to do.

New York law sets these signing and witnessing rules for the health care proxy:

  • You must sign and date the proxy in the presence of two adult witnesses, who must also sign it.[1]
  • By signing, the witnesses state that you appeared to sign willingly and free from duress.[1]
  • The person you name as your agent cannot act as one of the witnesses.[1]
  • If you live in a mental hygiene facility, at least one witness must not be affiliated with the facility. If the facility is also a hospital, at least one witness must be a qualified psychiatrist or psychiatric nurse practitioner.[1]

New York law also keeps the health care proxy separate from a power of attorney: you cannot execute both on the same form or document.[1]

Remote Witnessing

New York’s proxy law also covers witnesses who join by audio-video conference rather than in person. If a remote witness does not personally know you, you must show that witness valid photo identification during the audio-video conference. The remote witness must then receive a legible copy of the proxy, sent by fax or electronic means, within twenty-four hours of you signing it. The remote witness signs that copy and transmits it back to you to complete the process.[1]

A New York living will covers the following issues:

  • Life-sustaining treatment.
  • Donation of organs after death.
  • Additional wishes and instructions.

New York Living Will Form Details

Document Name New York Living Will Form
State Form Name New York Health Care Proxy and Living Will
Signing Requirements Signed and dated by the declarant in the presence of two adult witnesses, who must also sign[1]
Validity Requirements New York Consolidated Laws, Section 2981
Powers Limitation Not specified
Avg. Time to Fill Out 13 minutes
# of Fillable Fields 48
Available Formats Adobe PDF; Microsoft Word

Template Preview
Create a free high quality New York Living Will online now!

Steps to Fill Out the Form

To fill out your New York living will, follow the form in order: complete your declaration, record your health care choices, and finish the Medical Power of Attorney section before you sign. Each step below tells you which page of the form it covers and what to do there.

If you download the form as a PDF, you can fill it in online with our PDF editor. For more efficiency, you can also use our Online Forms Building Software to build the document from scratch.

  1. Complete the declaration (page 2). Enter your full name and state that you want to make health care and end-of-life decisions in advance, naming someone you trust to help carry them out.
    Name inserting part of New York living will form
  2. Initial your health care and end-of-life care choices (page 2). Choose whether you want life-sustaining treatment continued or withheld if death is otherwise certain and there is no reasonable hope of recovery, then initial the option that matches your wishes.
    Attitude to life prolongation specification section of living will for New York
  3. Add Additional Instructions (page 3, optional). Use this section for any personal instructions the form’s standard choices do not cover, including your wishes about burial or funeral arrangements for your family to follow.
    Other medical treatment instructions section of New York living will
  4. Appoint your health care agent (page 3). Name the person you trust to make medical decisions for you if you cannot make them yourself, and list their contact information.
  5. Name a substitute agent (page 4). Add a backup agent you trust in case your first choice is unable or unwilling to serve.
  6. Review the powers granted to your agent (page 4). The form lists the specific powers, lettered A through J, that your agent will hold. Cross out any power you do not want your agent to have, based on your personal wishes.
  7. Review when the Medical Power of Attorney takes effect (page 6). This section explains when your agent’s authority begins, often after a medical event that leaves you unable to decide for yourself, and confirms whether your agent can access your health records under HIPAA.
  8. Review the remaining Medical Power of Attorney provisions (page 7). These items cover the general terms of the power of attorney, including how long it lasts.
  9. Review governing law and revocation (page 8). This section confirms that New York law governs the document and explains how you can revoke it later if your personal wishes change.
  10. Sign and date before two witnesses (page 8). Sign and date the document in the presence of two adult witnesses. Neither witness may be the agent you named.
    Signatures section of New York living will form
  11. Have your two witnesses complete the Witness Acknowledgment (page 8). Each witness signs the acknowledgment section, confirming that you appeared to sign willingly and free from duress.

Frequently Asked Questions

How Do I Complete a Living Will in New York?

You complete a living will in New York by signing the health care proxy in the presence of two adult witnesses, who must also sign it. By signing, the witnesses state that you appeared to sign willingly and free from duress. The person you name as your agent cannot serve as one of the witnesses.[1] The sections below walk through the signing rules and the steps for filling out the form.

Who Can Witness a New York Living Will?

Your witnesses must be adults, and the individual you name as your health care agent cannot serve as one of them. If you live in a mental hygiene facility, at least one witness must not work for the facility, and if the facility is also a hospital, one witness must be a qualified psychiatrist or psychiatric nurse practitioner.[1] Witnesses can also join by audio-video conference under the rules described above.


General information, not legal or tax advice.

Sources

  1. N.Y. Pub. Health Law § 2981.
Published: May 18, 2022
Mara Erlach
Mara Erlach
Writer & Attorney
Mara has been practicing estate planning and trust law in California since 2003, taking pride in helping clients of all backgrounds and asset profiles form a complete and customized estate plan. Her specialties are: estate planning, wills and trusts, trust and probate administration.