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Arizona living will form
Download the August 2026 Arizona Living Will packet, the sample living will in A.R.S. § 36-3262, for stating wishes about life sustaining treatment and comfort care if you cannot speak for yourself. Get the form in editable Word and true fillable PDF. Add the completed sample PDF if you want a filled-in reference.
A state-specific living will packet, reviewed against the current Arizona statute and ready for instant secure access.
The document tracks the § 36-3262 sample elections for terminal condition, comfort care limits, pregnancy, treat-until, and prolong-life choices, plus write-in additional desires.
For standalone use, Arizona requires one qualified adult witness or a notary under §§ 36-3261 and 36-3221. Your health care agent and anyone directly involved in providing your health care at signing cannot serve in that role.
Download the files, complete them on your own device, then print and execute the form. Your personal details are never entered into an online form builder.
This download includes 1 document in editable Word and fillable PDF formats. Use the Word version for editing; the fillable PDF can be completed on screen, then printed and signed.
Review the complete form text below before purchasing. Your licensed download in editable Word and fillable PDF is delivered after checkout.
LIVING WILL
(Arizona Revised Statutes § 36-3262 sample)
Any writing that meets the requirements of A.R.S. Title 36, Chapter 32, Article 2 may be used to create a living will. A person may write and use a living will without writing a health care power of attorney or may attach a living will to the person's health care power of attorney. The following form tracks the sample living will offered in A.R.S. § 36-3262. Arizona offers the form as a sample only and does not prevent a person from using other language or another form.
This Living Will may be used without a Health Care Power of Attorney or attached to one. If you use both documents, keep and provide them together so your treatment directions are available to your agent and health care providers.
Name of Principal: ________________________________________________
Some general statements concerning your health care options are outlined below. If you agree with one of the statements, you should initial that statement. Read all of these statements carefully before you initial your selection. You can also write your own statement concerning life-sustaining treatment and other matters relating to your health care. You may initial any combination of paragraphs 1, 2, 3 and 4 but if you initial paragraph 5 the others should not be initialed.
(___) 1. If I have a terminal condition I do not want my life to be prolonged and I do not want life-sustaining treatment, beyond comfort care, that would serve only to artificially delay the moment of my death.
(___) 2. If I am in a terminal condition or an irreversible coma or a persistent vegetative state that my doctors reasonably feel to be irreversible or incurable, I do want the medical treatment necessary to provide care that would keep me comfortable, but I do not want the following:
(___) (a) Cardiopulmonary resuscitation, for example, the use of drugs, electric shock and artificial breathing.
(___) (b) Artificially administered food and fluids.
(___) (c) To be taken to a hospital if at all avoidable.
(___) 3. Notwithstanding my other directions, if I am known to be pregnant, I do not want life-sustaining treatment withheld or withdrawn if it is possible that the embryo/fetus will develop to the point of live birth with the continued application of life-sustaining treatment.
(___) 4. Notwithstanding my other directions I do want the use of all medical care necessary to treat my condition until my doctors reasonably conclude that my condition is terminal or is irreversible and incurable or I am in a persistent vegetative state.
(___) 5. I want my life to be prolonged to the greatest extent possible.
OTHER OR ADDITIONAL STATEMENTS OF DESIRES
You may write your own statement concerning life-sustaining treatment and other matters relating to your health care in the box below, or attach additional special provisions or limitations.
Initial only one of the following attachment choices:
(___) I have attached additional special provisions or limitations to this document to be honored in the absence of my being able to give health care directions.
(___) I have not attached additional special provisions or limitations to this document to be honored in the absence of my being able to give health care directions.
SIGNATURE OF PRINCIPAL
Standalone living wills are verified in the same manner as a health care power of attorney under A.R.S. §§ 36-3261 and 36-3221. Do not date or sign or mark this Living Will until your witness or notary is present.
Signature or Mark of Principal: ________________________________________
Date: ____________________________
EXECUTION: ONE QUALIFIED ADULT WITNESS OR A NOTARY
A witness or notary may not be a person designated to make medical decisions for the principal or a person directly involved in providing health care to the principal at the time of execution. Because this form provides for one witness, the witness also may not be related to the principal by blood, marriage, or adoption and may not be entitled to any part of the principal's estate by will or operation of law at the time of execution.
COMPLETE EITHER THE WITNESS ALTERNATIVE OR THE NOTARY ALTERNATIVE. You need only one path.
WITNESS ALTERNATIVE
Witness Affirmation. I affirm that I am an adult and was present when the principal dated and signed or marked this Living Will. At that time, the principal appeared to be of sound mind and free from duress. I am not designated to make medical decisions on the principal's behalf and I am not directly involved in providing health care to the principal at the time of execution. Because I am the sole witness, I am not related to the principal by blood, marriage, or adoption and I am not entitled to any part of the principal's estate by will or operation of law at the time of execution.
Signature of Witness: ________________________________________
Printed Name of Witness: ________________________________________
Date: ______________________
Address: ____________________________________________________
City, State, ZIP: ________________________________________
OR
NOTARY ALTERNATIVE
Use this path instead of the witness path. Leave the witness alternative blank if you use a notary.
State of Arizona, County of: ____________________________
Subscribed and sworn to or affirmed before me on __________________ by ____________________________ (name of principal).
Signature of Notary Public: ______________________________________
Printed Name of Notary Public: ____________________________________
My commission expires: ________________________
Notary seal / stamp area (leave clear space below for the official seal).
COMPLETE ONLY IF THE PRINCIPAL IS PHYSICALLY UNABLE TO SIGN OR MARK
The principal directly indicated to me that this Living Will expresses the principal's wishes and that the principal intended to adopt it at this time. Complete this block only when A.R.S. § 36-3221(B) applies. Leave it blank for ordinary execution.
Signature of Witness or Notary: ____________________________________
Printed Name: ________________________________________
Role (Witness or Notary): ____________________________
Date: ______________________
Legal currency, verified
This Arizona living will lets you record treatment directions for situations when you cannot speak for yourself. It tracks the sample living will in A.R.S. § 36-3262 and may be used alone or attached to a health care power of attorney.
Verified August 2026 against A.R.S. §§ 36-3262, 36-3261, and 36-3221. Arizona offers the living will form as a sample only and permits another writing that meets the article. A living will may stand alone or attach to a health care power of attorney. If the living will is not part of a health care power of attorney, it is verified the same way as a health care power of attorney under § 36-3221.
Date and sign or mark the living will before one qualified adult witness or a notary. The witness or notary may not be a person designated to make medical decisions for you or someone directly involved in providing your health care at signing. Because this form uses one witness, that witness also may not be related to you by blood, marriage, or adoption and may not be entitled to any part of your estate by will or operation of law at signing.
The form covers the sample living will elections for terminal condition, comfort care with optional CPR, artificial food and fluids, and hospital limits, a pregnancy direction, treat-until and prolong-life choices, write-in additional desires, the I have / I have not attachment pair, principal signature, one-witness or notary execution, and an optional unable-to-sign verification.
Editable Word and true fillable PDF of the complete Arizona living will. A completed sample PDF is available separately as a filled-in reference. Customer support and lifetime update access are included with your purchase.
This form is not legal advice. Consider speaking with an Arizona attorney about your circumstances.
ILRG is committed to top quality legal forms that are valid in all states. If you are not 100 percent satisfied after purchase, contact us for a full refund.
Yes. It tracks the sample living will in A.R.S. § 36-3262. Arizona offers the form as a sample only and permits another writing that meets the article.
If the living will is not part of a health care power of attorney, date and sign or mark it before one qualified adult witness or a notary under A.R.S. §§ 36-3261 and 36-3221. You need only one path.
The witness may not be a person designated to make medical decisions for you or someone directly involved in providing your health care at signing. Because this form uses one witness, that witness also may not be related to you by blood, marriage, or adoption and may not be entitled to any part of your estate by will or operation of law at signing.
Yes. Arizona allows a living will alone or as an attachment to a health care power of attorney. If you use both, keep them together so your agent and providers have your treatment directions.
Both contain the same form text. Use Word to edit the document or the fillable PDF to complete fields on screen, including the multiline additional-desires box. Print the finished form and execute it using the witness or notary method. Your purchase includes customer support for the download and lifetime update access when we revise the form.