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Ohio health care form
Download the August 2026 Ohio Living Will Declaration packet, tracking Ohio Revised Code Chapter 2133, to record your wishes about life-sustaining treatment in a terminal condition or permanently unconscious state. Get the declaration in editable Word and true fillable PDF. Add the completed sample PDF if you want a filled-in reference.
A state-specific ohio living will declaration packet, reviewed against the current Ohio statute and ready for instant secure access.
Records your direction on life-sustaining treatment when you are in a terminal condition or permanently unconscious state, with comfort-care language aligned to § 2133.01.
Execute with two eligible adult witnesses or a notary acknowledgment with sound-mind attestation. Ohio does not require both (§ 2133.02).
Complete the files on your own device, then print and sign with two eligible witnesses or a notary. 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.
See page 1 of the actual blank PDF and review selected instrument language with a representative content summary below. The complete formatted declaration is delivered after checkout.
OHIO LIVING WILL DECLARATION
END-OF-LIFE TREATMENT DIRECTIONS · ORC CHAPTER 2133
PUBLICLEGAL FORM OH2549 · REV. 08/2026
The form opens with your full legal name, date of birth, and address so physicians and facilities can identify the declaration with certainty.
Full legal name: ________________________________________________
Date of birth: ______________________
Street address / City, State, ZIP: ______________________________________
You revoke prior living wills, state that you are of sound mind, and direct that your dying not be artificially prolonged. Definitions track § 2133.01 for adult, attending physician, comfort care, CPR, life-sustaining treatment, nutrition and hydration, permanently unconscious state, and terminal condition.
You may name up to three people for your attending physician to try to notify before life-sustaining treatment is withheld or withdrawn. If you name no one, Ohio law supplies a default notification order (guardian, spouse, adult children, parents, or a majority of available adult siblings) under § 2133.05.
If you are in a terminal condition or a permanently unconscious state and unable to make health-care decisions, you direct your physician to let you die naturally with comfort care only, including authority to administer no life-sustaining treatment (including CPR), issue a DNR order, and take no action that only postpones death.
Withholding or withdrawing artificially supplied nutrition and hydration while you are permanently unconscious requires a separate, conspicuous Special Instructions authorization with your initials or signature under § 2133.02(A)(3).
You may check a box and initial if you want the living will to serve as DNR identification under § 2133.07(B). A separate physician DNR order may still be required under facility practice and §§ 2133.21 to 2133.26.
Sign and date the declaration, then complete either two eligible adult witnesses or a notary acknowledgment with sound-mind attestation. Both paths are not required (§ 2133.02). Witnesses may not be related by blood, marriage, or adoption, may not be your attending physician, and may not be the administrator of a nursing home where you receive care.
Ohio law no longer allows an anatomical gift to be made inside a living will. The packet ends with a detachable Ohio Donor Registry Enrollment Form, as required by § 2133.07(C), for optional registration through the Bureau of Motor Vehicles process.
This is a free representative preview of the declaration’s structure and key elections: selected instrument language with a representative content summary, not the complete executable form. After checkout you receive the complete formatted Ohio Living Will Declaration in editable Word and true fillable PDF, including the detachable donor registry page. An optional completed sample with fictitious data is available separately.
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This Ohio Living Will Declaration records your direction that life-sustaining treatment, including artificially or technologically supplied nutrition and hydration, be withheld or withdrawn if you are unable to make informed medical decisions and you are in a terminal condition or a permanently unconscious state. Comfort care continues. It does not appoint a health-care agent.
The form is an independently authored PublicLegal instrument that tracks the Modified Uniform Rights of the Terminally Ill Act in Ohio Revised Code Chapter 2133. It covers execution under § 2133.02 (two eligible adult witnesses or notary acknowledgment with sound-mind attestation), the permanent-unconsciousness nutrition and hydration authorization rules in § 2133.02(A)(3), optional use as DNR identification under § 2133.07(B), and the detachable Ohio Donor Registry Enrollment Form required by § 2133.07(C). It is not a commercial reproduction of the multi-organization consensus living will form.
You must sign and date the declaration. Execution is complete with either two eligible adult witnesses or a notary public acknowledgment. Both paths are not required. Witnesses must not be related by blood, marriage, or adoption, must not be your attending physician, and must not be the administrator of a nursing home where you receive care (§ 2133.02).
Your purchase includes the Ohio Living Will Declaration in editable Word (.docx) and a true fillable PDF, including the detachable donor registry page. An optional completed sample PDF with fictitious data is available separately as a fill-in reference.
Pair this living will with the Ohio Durable Power of Attorney for Health Care to appoint an agent for broader health-care decisions, and with the Ohio Statutory Form Power of Attorney for property and finances. If both a living will and a health-care power of attorney exist and conflict on life-sustaining treatment while you are terminal or permanently unconscious, the living will controls to that extent.
This form is not legal advice. PublicLegal provides self-help legal forms and information. Consult an Ohio 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.
Ohio Chapter 2133 authorizes living will declarations and sets execution and content rules, but it does not prescribe a single mandatory fill-in blank the way some states do. This is an independently authored PublicLegal form that tracks Chapter 2133. It is not a commercial reproduction of the multi-organization 2016 consensus living will form.
Sign and date it. Then complete either two eligible adult witnesses or a notary acknowledgment with the sound-mind attestation. Both paths are not required (ORC § 2133.02). Witnesses must not be related by blood, marriage, or adoption, must not be your attending physician, and must not be the administrator of a nursing home where you receive care.
If you want artificially or technologically supplied nutrition and hydration withheld or withdrawn while you are in a permanently unconscious state, Ohio requires a conspicuous authorization plus your initials or signature adjacent to it (§ 2133.02(A)(3)). Complete that section only if that is your wish.
No. Use the Ohio Durable Power of Attorney for Health Care at /forms/states/oh-powerofattorneyhealth-dur.html to appoint an agent for broader health care decisions. If both documents exist and conflict on life-sustaining treatment while you are terminal or permanently unconscious, the living will controls to that extent.
Both contain the same declaration text. Use Word to edit or the fillable PDF to complete fields on screen. Print either version, then add wet-ink initials and signatures on paper using a permitted execution method.