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Florida statutory health care form
Download the August 2026 Florida Living Will packet, Florida's suggested statutory form under § 765.303, for recording your wishes about life-prolonging procedures and naming a surrogate to carry them out. 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 statutory living will packet, reviewed against the current Florida statute and ready for instant secure access.
Reproduces the § 765.303 suggested form in full, including the 2015 two-physician determination language and the optional surrogate designation.
A living will executed under § 765.302 establishes a rebuttable presumption of clear and convincing evidence of your wishes, the strongest self-help evidence Florida law gives.
Download the files, complete them on your own device, then sign before two witnesses. 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 (editable Word and fillable PDF) is delivered after checkout.
LIVING WILL
(Florida Statutes § 765.303)
Declaration made this _______ day of ______________________, 20_____.
I, ______________________________________________________________, willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare that, if at any time I am incapacitated and (initial as applicable):
________ I have a terminal condition
or ________ I have an end-stage condition
or ________ I am in a persistent vegetative state
and if my primary physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.
It is my intention that this declaration be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and to accept the consequences for such refusal.
In the event that I have been determined to be unable to provide express and informed consent regarding the withholding, withdrawal, or continuation of life-prolonging procedures, I wish to designate, as my surrogate to carry out the provisions of this declaration:
Name: __________________________________________________________
Address: ________________________________________________________
City/State/Zip Code: ________________________________________________
Phone: __________________________________________________________
Your living will remains valid even if you do not designate a surrogate. (Fla. Stat. § 765.303(2))
I understand the full import of this declaration, and I am emotionally and mentally competent to make this declaration.
Additional instructions (optional): __________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
IN WITNESS WHEREOF, I have signed this declaration on the date first written above.
Name: __________________________________________________________________
Signed: ______________________________________________________________
Witness requirements (Fla. Stat. § 765.302(1)): This declaration must be signed by you in the presence of two subscribing witnesses, at least one of whom is neither your spouse nor your blood relative. If you are physically unable to sign, one of the witnesses must subscribe your signature in your presence and at your direction.
Witness #1: Witness #2:
Signature: _________________________ Signature: _________________________
Printed Name: _____________________ Printed Name: _____________________
Address: ___________________________ Address: ___________________________
_________________________________ _________________________________
Phone: ____________________________ Phone: ____________________________
Legal currency, verified
This Florida living will records your wishes about life-prolonging procedures if you are ever unable to speak for yourself and you have a terminal condition, an end-stage condition, or are in a persistent vegetative state. It follows the suggested statutory form in Florida Statutes § 765.303, under Part III of Chapter 765 (the Health Care Advance Directives chapter), and it lets you designate a surrogate to carry out your instructions.
The suggested living will form in § 765.303 was last revised effective October 1, 2015 (ch. 2015-153), and is unchanged through the 2025 Florida Statutes. This packet reproduces the current suggested form in full — including the two-physician determination language added in 2015 — reviewed and verified against the current statute in August 2026.
You initial the conditions under which the declaration applies — a terminal condition, an end-stage condition, a persistent vegetative state — and direct that life-prolonging procedures be withheld or withdrawn once your primary physician and another consulting physician determine there is no reasonable medical probability of recovery, while you continue to receive comfort care and pain relief. You may name a surrogate to carry out the declaration (your living will remains valid without one), and you may add any additional instructions.
You must sign the declaration in the presence of two subscribing witnesses, and at least one witness must be neither your spouse nor your blood relative (§ 765.302(1)). If you are physically unable to sign, one of the witnesses must sign for you in your presence and at your direction. Florida does not require notarization. A properly executed living will establishes a rebuttable presumption of clear and convincing evidence of your wishes (§ 765.302(3)). Give a copy to your physician so it becomes part of your medical records.
Your purchase includes the Florida Statutory Living Will form in two formats: an editable Word (.docx) file, and a fillable PDF you can complete on screen before printing and signing.
A living will records your own treatment wishes. To name the person who makes health care decisions for you, Florida provides a separate statutory form: the Florida Designation of Health Care Surrogate (Part II of Chapter 765).
This form is not legal advice and does not replace the advice of a Florida attorney about your specific situation.
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Yes. This packet reproduces the suggested living will form in Fla. Stat. § 765.303, last revised effective October 1, 2015, and unchanged through the 2025 Florida Statutes. Reviewed and verified against the current statute in August 2026.
No. Florida requires you to sign in the presence of two subscribing witnesses, and at least one witness must be neither your spouse nor your blood relative (§ 765.302(1)). If you cannot sign, a witness may sign for you in your presence and at your direction.
Only if you are incapacitated, you have initialled a covered condition (a terminal condition, an end-stage condition, or a persistent vegetative state) and your primary physician and another consulting physician determine there is no reasonable medical probability of your recovery.
No. A living will records your own instructions about life-prolonging procedures. A designation of health care surrogate (Part II of Chapter 765) names the person who makes decisions for you. Many Floridians complete both.
Both contain the same form text. Use the editable Word (.docx) file to type in your details, or the fillable PDF to complete the form on screen. Either way, print the finished document and sign it before two witnesses.