Free Louisiana Living Will Form

A Louisiana living will is a legal document about life-sustaining procedures. It states whether a person wants those procedures withheld or continued if they are later diagnosed with a terminal or irreversible condition and cannot communicate their wishes. A living will form lets someone put those instructions in writing before a crisis happens.

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 If you notice an error or outdated information, please contact us.

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FormsPal’s free Louisiana template combines this declaration with a medical power of attorney, so these documents also name a health care agent to make decisions the declarant cannot make personally. The declarant signs and dates the document, and Louisiana law sets rules for how it must be witnessed.

Signing Requirements and Laws

Louisiana’s living will law appears in Title 40 of the Louisiana Revised Statutes, in the chapter on declarations concerning life-sustaining procedures. The declarant signs a written declaration, the statutory form includes two witness signature lines, and the completed document tells physicians and family what care to provide or withhold.

The declarant must sign and date the document.[2] If you are physically unable to sign, Louisiana law lets you make an oral or nonverbal declaration in the presence of two witnesses at any time after the diagnosis of a terminal and irreversible condition (La. R.S. 40:1151.2(A)(3)).[2.1]

If at any time i should have an incurable injury, disease or illness, or be in a continual profound comatose state with no reasonable chance of recovery, certified to be a terminal and irreversible condition by two physicians who have personally examined me, one of whom shall be my attending physician, and the physicians have determined that my death will occur whether or not life-sustaining procedures are utilized and where the application of life-sustaining procedure would serve only to prolong artificially the dying process, i direct (initial one only):

Louisiana’s statutory declaration form, La. Rev. Stat. § 40:1151.2 [2]

Under this language, the declarant chooses one of two options once two physicians, one of them the attending physician, certify the condition described above:[2]

  • Withhold or withdraw all life-sustaining procedures, including nutrition and hydration.
  • Withhold or withdraw life-sustaining procedures except for nutrition and hydration.

Louisiana’s statutory declaration form includes two witness signature lines. By signing, each witness confirms that the declarant is personally known to them and appears to be of sound mind.[2]

In practice, a declarant who wants to cancel a living will typically does so in writing or by telling their physician directly, since medical staff need current instructions on file.

Once a physician learns about the living will, it is standard practice for the document to go into the patient’s file. This lets the whole care team see the instructions.

Under La. R.S. 40:1151.3, you may revoke your declaration at any time, whatever your mental state or competency, by destroying it, by a signed and dated written revocation, or by an oral or nonverbal expression of intent. The revocation takes effect once it is communicated to your attending physician.[4.1]

Each witness must be a competent adult who is not related to you by blood or marriage and who would not be entitled to any part of your estate (La. R.S. 40:1151.1(15)).[3.1]

Louisiana Living Will Form Details

Document Name Louisiana Living Will Form
State Form Name Declaration
Signing Requirements Two Witnesses
Validity Requirements La. Rev. Stat. § 40:1151.2
State Laws: Louisiana Revised Statutes on Declarations Concerning Life-Sustaining Procedures
Keep the signed and witnessed declaration where it can be found quickly. Give a copy to your physician, to the health care agent named in the power of attorney section, and to any family members or friends who should know your wishes.

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Does a Living Will in Louisiana Require the Declarant’s Signature?

Yes, though the signature rule verified for this page belongs to a related document rather than the general declaration described above: Louisiana’s advance directive for behavioral health treatment. Under La. Rev. Stat. § 28:224, this directive is valid only if it is signed by the principal[1.2] and witnessed by two competent witnesses.[1.1] It must also come with a written psychiatric examination attesting to the principal’s ability to make reasoned decisions about behavioral health treatment.[1.2]

“Behavioral health treatment” refers to mental health and substance use treatment decisions, as distinct from the physical life-sustaining procedures covered by the living will declaration above. A person may complete one directive, both, or neither, depending on what kind of future decisions they want to plan for.

The witnesses must attest to three things:[1.2]

  • They know the principal.
  • The principal signed the directive in their presence.
  • The principal did not appear unable to make reasoned decisions, or under duress, fraud, or undue influence.

Individuals listed in La. Rev. Stat. § 28:234 cannot serve as witnesses to this directive.[1.2]

Because this directive covers different circumstances than the living will declaration, it is worth reviewing both documents with someone you trust before deciding which, if either, fits your situation. Someone who wants both can typically complete them together, since advance-directive packets often combine several related advance directives in a single filing.


How Do You Fill Out a Louisiana Living Will Form?

FormsPal’s Louisiana template combines the living will declaration with a power of attorney. This guide walks through both legal documents in order, with the page numbers noted for each step.

  1. Declaration Statement (page 2). Fill in the day, month, and year, your full name, and your residential address at the top of the declaration.
  2. Health Care Treatments to Withhold (page 2). Initial next to any treatments you do not want if you become unable to communicate. This includes CPR, nutrition and hydration, ventilation, dialysis, blood transfusions, organ transplants, or other life-sustaining treatment.
  3. End-of-Life Conditions (pages 2-3). Initial the conditions under which you want your instructions to apply. Choices include being unable to communicate, a deteriorated mental condition, an end-stage condition, a terminal condition, or a physician’s determination.
  4. Additional Instructions (page 3, optional). Add any further care wishes in the blank lines.
  5. Appoint Your Agent (page 3). Enter the name, address, and phone number of the person you want to make care decisions for you as your agent.
  6. Name a Substitute Agent (page 4). Enter the name, address, and phone number of a backup agent who can act if your first choice is unavailable.
  7. Review Powers Granted to Your Agent (pages 4-6). Read through the listed powers your agent will hold, including care decisions, records access, consent to treatment, pain relief, and personal care decisions.
  8. Review the Medical Power of Attorney Terms (pages 6-7). Read the terms covering when the power of attorney takes effect, HIPAA record access, agent conduct, and how to revoke a prior document.
  9. Sign and Date (page 8). Sign and date the document in front of two witnesses, as directed just above the signature line.
  10. Witness Acknowledgment and Signatures (page 8). Have each of your two witnesses print their name and address, then sign and date the witness acknowledgment section.

General information, not legal or tax advice.

Sources

  1. Louisiana Civil Code §§ La. R.s to 28:224.
    • 1.1 La. R.S
    • 1.2 § 28:224
  2. La. Rev. Stat. § 40:1151.2.
    • 2.1 § 40:1151.2(A)(3)
  3. La. Rev. Stat. § 40:1151.1
    • 3.1 § 40:1151.1(15)
  4. La. Rev. Stat. § 40:1151.3
    • 4.1 § 40:1151.3(A)
Published: Jun 19, 2024
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.