Free Kentucky Living Will Form

A Kentucky living will is a written advance directive. It lets you state, in advance, which medical treatments you want or refuse if you become unable to communicate your wishes, such as after a serious illness or accident. It is one type of living will form recognized under Kentucky law.

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 If you notice an error or outdated information, please contact us.

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The Kentucky Living Will form is part of the Kentucky advance directive. In this document, you can decide and arrange for basic health care services in advance:

  • Choose the person responsible for choosing your treatment
  • Refuse medical intervention or demand to fight for your life
  • Refuse or require artificial feeding or hydration services
  • State your preference about organ or tissue donation

Signing Requirements and Laws

A Kentucky living will is valid when it is in writing, dated, and signed by you, or by someone else at your direction. You must then have two or more adult witnesses sign in your presence and in each other's presence. As an alternative, you can have the document acknowledged before a notary public or another person authorized to administer oaths.[1]

“An advance directive shall be in writing, dated, and signed by the grantor, or at the grantor's direction, and either witnessed by two (2) or more adults in the presence of the grantor and in the presence of each other, or acknowledged before a notary public or other person authorized to administer oaths.”

Ky. Rev. Stat. § 311.625[1]

Kentucky law also limits who can serve as a witness. None of the following may act as a witness:[1]

  • A blood relative of yours
  • A beneficiary named in your estate
  • An employee of the health care facility where you are a patient, unless that employee is also a notary public
  • Your attending physician
  • Anyone financially responsible for your care

Each witness must be at least eighteen years old. If you name a health care surrogate, note one restriction. An employee, owner, director, or officer of a health care facility where you are a resident or patient cannot serve as your surrogate. The one exception is a person related to you within the fourth degree of consanguinity or affinity, or a member of the same religious or fraternal order.[1]

Kentucky law also refers to this document as an advance directive. Many people pair it with a health care surrogate designation, as this form does, so one document both states your treatment wishes and names a decision-maker.

Does a Living Will Need to Be Notarized in Kentucky?

Yes, but notarization is only one option. Kentucky law lets you validate a living will either of two ways. You can have it signed in front of two or more adult witnesses, or have it acknowledged before a notary public or another person authorized to administer oaths. You do not need both.[1]

The Living Will Form includes two sections:

  1. Health Care Surrogate — appointment of family members or close friends. In the future, they can make decisions about your further treatment if you cannot make them yourself.
  2. Living Will section — determination of the desire for medical services to prolong life. To be completed so that your guardian and attending physician knows what your will is in this matter. It also lets you note your preference about organ or tissue donation.

Kentucky Living Will Form Details

Document Name Kentucky Living Will Form
State Form Name Kentucky Living Will Directive and Health Care Surrogate Designation
Signing Requirements Two Witnesses or Notary Public
Validity Requirements Ky. Rev. Stat. § 311.625
Avg. Time to Fill Out 13 minutes
# of Fillable Fields 48
Available Formats Adobe PDF; Microsoft Word
State Laws: Ky. Rev. Stat. § 311.625

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Steps to Fill Out the Form

Filling out the Kentucky Living Will form takes about ten minutes. Work through the declaration, the health care treatment choices, and the agent's powers in the form's own order, then sign in front of two witnesses or a notary public. The outline below follows the form section by section.

  1. Read the General Information. Page 1 explains what the document does and how the two parts, the health care surrogate designation and the living will, work together.
  2. Complete the Declaration. On page 2, enter today’s date and your name and address.
    Completing the declaration on the Kentucky living will form
  3. Initial the Health Care Treatments to Refuse. Also on page 2, initial next to each treatment you want to refuse if you become unable to decide for yourself.
  4. Initial the End-of-Life Care Conditions. Choose whether you want life-prolonging treatment or artificial feeding and hydration continued or withheld under the conditions the form describes.
    End-of-life care conditions section of a Kentucky living will template
  5. Add Additional Instructions (Optional). Page 3 has space to write any instructions the printed choices do not cover. If you would rather fill in and sign the PDF on screen, use our PDF editor.
  6. Appoint Your Agent. Name the person you want to make health care decisions for you if you cannot make them yourself.
    Appointing an agent on the Kentucky living will form
  7. Name a Substitute Agent. Page 4 lets you name a backup agent in case your first choice is unable or unwilling to serve.
  8. Review the Agent’s Powers. Pages 4 through 6 list the specific powers your agent may exercise, including your preference on organ or tissue donation. Review each item. Our chat with PDF tool can help you understand a long section like this before you sign.
    Agent’s powers section of the Kentucky living will form
  9. Review the Standard Provisions. Pages 6 through 8 set out the general terms that apply to the document, such as when it takes effect.
  10. Sign and Date. Sign and date the form on page 8.
    Signing part of form for living will for Kentucky
  11. Complete the Witness Acknowledgment. Have your two witnesses sign and print their information in the Witness Acknowledgment block on page 8.
seal of kentucky state
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General information, not legal or tax advice.

Sources

  1. Ky. Rev. Stat. § 311.625.
Published: Aug 17, 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.