YOU'RE ONLY FOUR EASY STEPS FROM GETTING YOUR CUSTOMIZED LIVING WILL DOCUMENT

1. In the table below, enter the information specific to your needs.
2. Use your credit card to pay $14.95 for the custom-tailored document.
3. Print the document that is immediately emailed to you.
4. Sign the document in front of a notary public. Breathe a sigh of relief--you have taken care of your affairs!

Below are the descriptions of the information we need from you.	Give us your information in the boxes below.	Below is helpful information to quickly guide you through this process.
*Denotes Required Information Information About The Will Maker And The Living Will
Enter the declarant's full name:		Tell me who the declarant is.
Select the declarant's state:	Select A State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Enter the declarant's birthdate:		Enter the date in this format: MM/DD/YYYY
Enter the declarant's social security number:		Enter the social security number in this format: 555-55-5555
Enter the declarant's street address:		Enter the address like this: 3422 E. Kipper Rd.
Enter the declarant's city:
Enter the declarant's county:		Note: this is asking for COUNTY not COUNTRY
Enter the city where the document will be signed:
Enter the county where the document will be signed:		Note: this is asking for COUNTY not COUNTRY
Select the state where the document will be signed:	Select A State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Enter the agent's full name: Tell me who the agent is. Enter the agent's relationship to the declarant: Examples: "Son", "Daughter", "Cousin" Enter the agent's street address: Enter the address like this: 8344 Combe Rd. Enter the agent's city:   Select the agent's state: Select A State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Enter the agent's current telephone number: The telephone number will NOT be given to any third parties. It is included in your living will just so the doctor can quckly reach your agent, if necessary. Enter the alternate agent's full name: Tell me who the alternate agent is. Enter the alternate agent's relationship to the declarant: Examples: "Son", "Daughter", "Cousin" Enter the alternate agent's street address: Enter the address like this: 4429 S. Kennebeck Dr. Enter the alternate agent's city:   Select the alternate agent's state: Select A State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Enter the alternate agent's current telephone number:
Enter the second alternate agent's full name: Tell me who the alternate agent is. Enter the second alternate agent's relationship to the declarant: Examples: "Son", "Daughter", "Cousin" Enter the second alternate agent's street address: Enter the address like this: 9833 Beverly Rd. Enter the second alternate agent's city:   Select the second alternate agent's state: Select A State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Enter the second alternate agent's current telephone number:

Declarant:

The Declarant is simply the person who is making and sigining the living will; he or she is the person who is declaring his or her intentions about administering or withholding life sustaining treatment. Living wills are often referred to as "Health Care Declarations", which is where the term "declarant" comes from.

Agent:

If you have been given the option to enter an Agent's name, it is because the State you selected has included this provision in its statutory living will form. If you enter an agent's name, that agent will be given power to make health care decisions for the declarant if the declarant him or herself is unable. In essence, naming a health care agent in your living will is like creating a health care power of attorney; it's just that you've combined two documents into one.

The authority you grant your agent is set forth in the state-specific form you generate on this website. You should carefully review the document to insure that you understand and are comfortable with what it says.

Alternate Agent:

The Alternate Agent is simply the "back-up" person in case the first agent can't serve. The alternate agent has all the same powers and discretion as the first agent, but those powers don't become effective until the first agent either resigns or refuses to serve. Click here for a description of the agent's role.