Free Wyoming Living Will Form

Signing Requirements and Laws

In Wyoming, the laws governing the creation and execution of a living will are specified under Title 35 of the Wyoming Statutes, which focuses on public health and safety. The specific sections that detail the requirements for a legally valid living will are crucial for ensuring that the document reflects your wishes and can be enforced when necessary.

To ensure that a living will is legally binding in Wyoming, several specific signing requirements must be met:

• Age and capacity. You must be at least 18 years old and of sound mental capacity at the time of the document’s execution.
• Written document. The living will must be in writing. Electronic forms are acceptable as long as they meet the standard requirements for written documents.
• Signature. The individual creating the living will (declarant) must sign the document with two qualified witnesses (W.S. 35-22-403).

The witnesses to signing a living will in Wyoming must be at least 18 years old. They cannot be individuals entitled to any portion of the declarant’s estate upon death under a will or by operation of law. The witnesses should not be healthcare providers directly involved in providing care to the individual, nor should they be employees of a healthcare provider treating the individual. While notarization is not a requirement in Wyoming, it is often recommended as it can add an extra layer of validity, especially if the document might be used in other jurisdictions.

According to W.S. 35-22-404, the declarant can revoke a living will at any time, regardless of their mental or physical condition. This revocation can be done either in writing, by physically destroying the document, or by verbally expressing the intent to revoke in the presence of a witness.

Wyoming Living Will Form Details

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Steps to Fill Out the Form

Following these steps, you can ensure that your Wyoming living will is properly completed and legally valid, providing clear instructions for your healthcare preferences.

1. Provide Basic Information

Please enter the current date, including the day, month, and year, in the designated fields at the top of the form. Next, please fill in your full name and address in the provided space.

2. Designate Your Healthcare Agent

In Part 1, under “Designation of agent,” fill in the name, address, city, state, zip code, home phone, work phone, and cell phone of the person you choose as your agent. If your agent cannot fulfill their role, designate an alternate agent by filling in their name, address, city, state, zip code, home phone, work phone, and cell phone.

3. Define the Agent’s Authority and Effectiveness

Under “Agent’s authority,” specify any limitations on your agent’s authority to make healthcare decisions. If there are none, leave this section blank. Next, choose when your agent’s authority becomes effective. You have three options:

• When your primary physician or primary healthcare provider determines you lack capacity.
• Only when your primary physician (and not any treating healthcare provider) determines you lack capacity.
• Immediately upon executing the directive.

Check and initial the appropriate box to indicate your choice.

4. Specify End-of-Life Decisions

In Part 2, under “End-of-Life decisions,” select whether you want to prolong life under certain conditions. Check and initial the box for your choice. Making these decisions in advance reduces stress for your loved ones during difficult times.

5. Address Artificial Nutrition and Hydration

State your preferences regarding artificial nutrition and hydration. Check and initial the boxes that apply:

• Want artificial nutrition regardless of condition.
• Do not want artificial nutrition regardless of condition.
• Want artificial hydration regardless of condition.
• Do not want artificial hydration regardless of condition.

These selections clarify your wishes about life-sustaining treatments in specific circumstances. Ensure that your choices align with your overall healthcare goals and values.

6. Indicate Preferences for Pain Relief and Other Wishes

Under “Relief from pain,” choose if you want treatment to alleviate pain or discomfort at all times or if you do not. Check and initial the appropriate box. In the “Other wishes” section, write any additional specific instructions, such as preferences for blood products, chemotherapy, diagnostic tests, surgeries, antibiotics, oxygen, or a wish to die at home if possible.

7. Donation of Organs and Tissues

In Part 3, indicate your preferences for organ and tissue donation upon death. Check and initial the applicable boxes:

• Arranged to give body to science.
• Arranged through Wyoming Donor Registry to give organs/tissues.
• Do not wish to donate your body, organs, or tissues.

Your organ and tissue donation choices can save lives and advance medical research.

8. Information About Your Healthcare Provider
In Part 4, provide your primary physician’s name, address, city, state, zip code, and phone number. Also, provide details of any healthcare institution or hospice with more information about your healthcare.

9. Sign and Date the Form
Sign and date the form in the designated spaces. Print your name and provide your address, city, state, and zip code.

9. Witness Signatures or Notary Public
Each witness must print their name, provide their address, sign, and date the form. Alternatively, a notary public can complete the acknowledgment section, including the date and commission expiration.

Other Wyoming Forms
Below are various other Wyoming templates completed by our users. Try our simple builder to customize these forms to your preferences.

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