Free Nebraska Living Will Form

The Nebraska living will, formally known as an “Advance Directive,” includes directives regarding using or refusing life-sustaining treatments. It becomes effective in Nebraska when a physician certifies that the individual is incapacitated and has a terminal condition or is in a persistent vegetative state.

The physician must consult with another physician who agrees with the diagnosis and prognosis. A living will form is also accompanied by a durable power of attorney for health care, which appoints someone to make medical decisions on the individual’s behalf if they cannot do so. This can cover a broader range of decisions than those typically included in a living will.

nebraska living will form

Create a high-quality Nebraska Living Will Form 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 Nebraska Living Will Form as a  PDF file or   Word file
Create a high-quality Nebraska Living Will Form online now!

Signing Requirements and Laws

In Nebraska, the statutory requirements for executing a living will are detailed in the Nebraska Revised Statutes, specifically in sections 20-401 to 20-416, collectively known as the “Rights of the Terminally Ill Act.” These laws set out the legal framework for the preparation and execution of living wills, ensuring that healthcare providers respect and follow the directives.

The living will must be signed by the declarant, the person making the living will. If the declarant is unable to sign, another individual may sign the document, but this must occur in the declarant’s presence and at the declarant’s explicit direction.

The signing of the living will must be witnessed by two competent adults or notarized. Importantly, these witnesses must not be:

  • The person who signed the living will on behalf of the declarant.
  • Related to the declarant by blood, marriage, or adoption.
  • Entitled to any portion of the declarant’s estate according to the laws of descent and distribution under Nebraska law.
  • Directly financially responsible for the declarant’s medical care.
  • A healthcare provider who is serving the declarant at the time the document is executed.

While notarization is not required, it can add a layer of formality and verification to the document, helping to ensure its acceptance in different medical facilities and states.

Nebraska Revised Statutes Section 20-404 provides specific provisions regarding the execution requirements. This section provides detailed instructions on the procedural aspects of creating a living will to protect the rights of individuals making critical end-of-life decisions.

Furthermore, the statutes allow for the revocation of a living will at any time, under any condition, as long as the revocation is communicated effectively. To ensure clarity and prevent any legal complications, it is recommended that any revocation of the contract be documented and communicated to the healthcare provider formally.

Nebraska Living Will Form Details

Document Name Nebraska Living Will Form
State Form Name Nebraska Advance Health Care Directive
Signing Requirements Two Witnesses
Validity Requirements Section 20-404
State Laws: Nebraska Revised Statutes, Sections 20-401 to 20-416

Template Preview
Create a high-quality Nebraska Living Will Form online now!

Steps to Fill Out the Form

Creating a living will (Advance Health Care Directive) in Nebraska is crucial in managing your health care preferences when you cannot communicate your wishes directly. Here’s how to properly fill out the Nebraska living will form to ensure your directives are clear and legally enforceable.

1. Complete Your Personal Information

Fill in your full name and address in the designated spaces. This information confirms your identity and ensures the document is specific to you.

2. Specify Your Medical Conditions

Clearly state the conditions under which you want life-sustaining treatment to be withheld or withdrawn. This typically includes being in a persistent vegetative state or having an incurable and irreversible condition that will result in death without life-sustaining treatment.

3. Provide Additional Directions

If you have any other specific instructions regarding your medical care, include them in the “Other directions” section. This might cover preferences for pain management, palliative care, or other treatments you wish to refuse or receive.

4. Sign and Date the Document

Sign and date the form in the presence of either two witnesses or a notary public. Your signature affirms your wishes as outlined in the directive.

5. Witness Signatures

If you use witnesses, they must sign the document and provide their addresses. The witnesses must watch you sign the document and confirm that you did so voluntarily. Ensure your witnesses meet the requirements: they cannot be your healthcare provider, an employee of your healthcare provider, or anyone who stands to inherit from you.

6. Notary Public (Optional)

Instead of witnesses, you can have the document notarized. The notary public will confirm your identity and ensure you sign the document voluntarily.

7. Distribute Copies

After completing the form, distribute copies to your healthcare agent, primary care physician, and any other relevant medical personnel or family members. Keeping a copy in an easily accessible place at home is also advisable.

seal of nebraska state
Other Nebraska Forms
Below are various other Nebraska templates completed by our users. Try our simple builder to customize these forms to your preferences.


Published: Jun 21, 2024