Free New Hampshire Living Will Form

A New Hampshire living will is a written advance directive. It lets you state, ahead of time, which medical treatments you want or refuse if illness or injury leaves you unable to communicate. A complete advance directive in New Hampshire typically pairs two documents:

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 If you notice an error or outdated information, please contact us.

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  • Living will. States which life-sustaining treatments to use or withhold if you become terminally ill, permanently unconscious, or in a similar condition.
  • Medical power of attorney. Appoints a health care agent to make medical decisions you cannot make yourself.

The New Hampshire living will form gives instructions on accepting or refusing medical treatment that could prolong life. A signed living will form takes effect once it reaches your attending physician and you are determined to be incapacitated and either terminally ill or permanently unconscious.

Signing Requirements and Laws

New Hampshire’s advance directive law, found in RSA Chapter 137-J, sets out how a living will must be signed to be valid. The advance directive must be signed by you in the presence of either of the following: two or more subscribing witnesses, or a notary public or justice of the peace.[1.2]

Before you sign, you must be given a disclosure statement in substantially the form the law sets out. Your completed document must also be substantially in the form set forth in RSA 137-J:20.[1.1]

To be legally binding in New Hampshire, the document must be:

  • Signed by you, or by another person on your behalf, in your presence and at your express direction.[1.2]
  • Witnessed by two or more eligible witnesses, or acknowledged before a notary public or justice of the peace.[1.2]
  • Accompanied, at signing, by witnesses who affirm that you appeared to be of sound mind and free from duress, and that you were aware of the document and signed it freely and voluntarily.[1.2]
The witnesses shall affirm that the principal appeared to be of sound mind and free from duress at the time the advance directive was signed and that the principal affirmed awareness of the nature of the document and signed it freely and voluntarily.
N.H. Rev. Stat. Ann. § 137-J:14

Choose your witnesses carefully. Neither witness may, at the time of signing, be your agent or surrogate, your spouse or heir at law, or a person entitled to any part of your estate under a will, trust, or other testamentary instrument or deed.[1.2]

A witness also cannot be your attending practitioner or a person acting under that practitioner’s direction or control. No more than one witness may be your health or residential care provider or that provider’s employee.[1.2] Using an ineligible witness can make your directive invalid.

New Hampshire also provides its own statutory combined advance directive form that pairs a living will with a durable power of attorney for health care.[2] You can use FormsPal’s version below instead, as long as it substantially matches what state law requires.[1.1]

If you are physically unable to sign, another person may sign your name for you, in your presence and at your express direction.[1.2] This careful selection of witnesses helps protect you from potential conflicts of interest and helps ensure the document reflects your genuine wishes.

A living will or similar document signed in another state and valid under that state's law is as effective in New Hampshire as if it had been signed under New Hampshire law (RSA 137-J:17).[1.3]

New Hampshire Living Will Form Details

Document NameNew Hampshire Living Will Form
State Form NameNew Hampshire Advance Directive
Signing RequirementsTwo or More Witnesses, or a Notary Public / Justice of the Peace
Validity RequirementsN.H. Rev. Stat. Ann. §§ 137-J:13 to 137-J:14
State Laws: New Hampshire Revised Statutes, Chapter 137-J

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A living will only covers your medical wishes. It does not manage your finances. If you also want someone to handle money matters if you become incapacitated, use a separate financial power of attorney alongside the medical power of attorney section of this document.

Steps to Fill Out the Form

This New Hampshire living will and medical power of attorney form combines your health care wishes and your agent’s authority in one document. State your wishes on pages 4 and 5, then appoint your agent on pages 5 and 6. Review the powers granted on pages 6 through 8, then sign with two witnesses on page 10.

  1. Complete the Declaration (page 4). Fill in the date and your name and address at the top of the Living Will and Advance Health Care Directive.
  2. Initial the health care treatments you refuse (page 4). Initial next to each listed treatment, including CPR, nutrition and hydration, ventilation, dialysis, blood transfusions, organ transplants, and any other artificial life-sustaining treatment, that you do not want if you become incapacitated.
  3. Initial the end-of-life conditions (pages 4-5). Initial which conditions, being unable to communicate and totally dependent on others, significant mental deterioration, an end-stage condition, a terminal condition, or a physician-determined vegetative state, should trigger withholding life-prolonging care.
  4. Add additional instructions on page 5 if you have any (optional). Write any further wishes on the blank lines, or leave this section blank if you have none.
  5. Appoint your health care agent (page 5). Enter the name, address, and phone number of the person you want to make medical decisions for you.
  6. Name a substitute agent (page 6). Enter the name, address, and phone number of a backup agent who can act if your first choice cannot.
  7. Review the powers granted to your agent (pages 6-8). Read Articles A through J, which give your agent authority over your medical decisions, records, and related matters unless you limited them above.
  8. Sign and date the document (page 10). Sign, print your name, and date the document in the signature block in the presence of your witnesses.
  9. Have two witnesses sign the document on page 10. Each witness prints their name, address, and city or state, then signs and dates the Witness Acknowledgment block.

How to Make a Living Will in New Hampshire

To make a living will in New Hampshire, sign the advance directive before two or more qualifying witnesses. You may instead sign before a notary public or justice of the peace.[1.2] Before you sign, you must receive the state’s required disclosure statement.[1.1]

Your document must substantially match the form New Hampshire law provides.[1.1] If you cannot sign yourself, someone else may sign your name for you, in your presence and at your direction.[1.2]

After you and your witnesses sign, store the original where it is easy to find in an emergency. Give copies to your health care agent, your primary physician, and any hospital where you receive regular care, so the document is on hand when it is needed.

Common Mistakes to Avoid

A few missteps can keep your New Hampshire living will from taking effect when you need it most. Most come down to who signs as a witness, whether you received the required disclosure statement first, and whether the document itself was signed correctly. Review the list below before you sign, so a technical error does not undo your planning.

  • Using an ineligible witness. Your agent or surrogate, your spouse or heir at law, your attending practitioner, or more than one health or residential care employee cannot witness your signature.[1.2]
  • Skipping the disclosure statement. You must receive the state’s required disclosure statement before you sign.[1.1]
  • Missing the signing requirement. The document is valid only if you sign before two or more qualifying witnesses, or before a notary public or justice of the peace.[1.2]
  • Storing the signed original where your agent or physician cannot find it when it is needed.
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Frequently Asked Questions

What Is a New Hampshire Living Will?

A New Hampshire living will is a written advance directive governed by RSA Chapter 137-J. It states which life-sustaining treatments you want or refuse if you become terminally ill, permanently unconscious, or otherwise unable to communicate.[1.1] It works alongside a medical power of attorney, which names a health care agent for decisions the living will does not cover. New Hampshire also provides a statutory form that combines both parts into one document.[2]


General information, not legal or tax advice.

Sources

Unless noted otherwise, the sources below are from the New Hampshire Revised Statutes Annotated.

  1. New Hampshire Revised Statutes Annotated §§ 137-J:13 to 137-J:14.
    • 1.1 § 137-J:13
    • 1.2 § 137-J:14
    • 1.3 § 137-J:17
  2. New Hampshire Revised Statutes Annotated § 137-J:20.
Published: Jun 20, 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.