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South Dakota statutory health care form
Download the August 2026 South Dakota Living Will Declaration packet, the sample declaration under SDCL § 34-12D-3 for directing life-sustaining treatment and artificial nutrition and hydration when you are in a terminal condition and cannot communicate. 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 declaration packet, reviewed against the current South Dakota statute and ready for instant secure access.
Tracks the Living Will Declaration sample in SDCL § 34-12D-3, including life-sustaining treatment and artificial nutrition and hydration initial elections required by § 34-12D-2.
Method 1 uses two adult witnesses. Method 2 uses a notary public. Choose one path under § 34-12D-2 after the 2023 amendment. Both methods are not required.
Complete the form on your device, then print, wet-initial your elections, and sign with two adult 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.
Review the complete form text below before purchasing. Your licensed download (editable Word and fillable PDF) is delivered after checkout.
SOUTH DAKOTA LIVING WILL DECLARATION
SDCL § 34-12D-3 sample form · Chapter 34-12D
This is an important legal document. A living will directs the medical treatment you are to receive in the event you are in a terminal condition and are unable to participate in your own medical decisions. This living will may state what kind of treatment you want or do not want to receive.
Prepare this living will carefully. If you use this form, read it completely. You may want to seek professional help to make sure the form does what you intend and is completed without mistakes.
This living will remains valid and in effect until and unless you revoke it. Review this living will periodically to make sure it continues to reflect your wishes. You may amend or revoke this living will at any time by notifying your physician and other health care providers. You should give copies of this living will to your family, your physician, and your health care facility. This form is entirely optional.
Execution under SDCL § 34-12D-2 (as amended by SL 2023, ch 115): the declaration must be signed by you, or by another person at your direction, and then either (1) witnessed by two adults, or (2) notarized by a notary public. Choose one method. Both methods are not required.
TO MY FAMILY, HEALTH CARE PROVIDER, AND ALL THOSE CONCERNED WITH MY CARE:
I, ____________________, direct you to follow my wishes for care if I am in a terminal condition, my death is imminent, and I am unable to communicate my decisions about my medical care.
With respect to any life-sustaining treatment, I direct the following:
(Initial only one of the following options. If you do not agree with either of the following options, space is provided below for you to write your own instructions.)
(___) If my death is imminent or I am permanently unconscious, I choose not to prolong my life. If life-sustaining treatment has been started, stop it, but keep me comfortable and control my pain.
(___) Even if my death is imminent or I am permanently unconscious, I choose to prolong my life.
(___) I choose neither of the above options, and here are my instructions should I become terminally ill and my death is imminent or I am permanently unconscious:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Artificial Nutrition and Hydration: food and water provided by means of a tube inserted into the stomach or intestine or needle into a vein.
With respect to artificial nutrition and hydration, I direct the following:
(Initial only one)
(___) If my death is imminent or I am permanently unconscious, I do not want artificial nutrition and hydration. If it has been started, stop it.
(___) Even if my death is imminent or I am permanently unconscious, I want artificial nutrition and hydration.
Date: ____________________
____________________ (your signature)
____________________ (your address)
____________________ (type or print your signature)
METHOD 1: Two Adult Witnesses (SDCL § 34-12D-2)
Use this method if two adults will witness your signature. Leave Method 2 blank.
The declarant voluntarily signed this document in my presence.
First Witness
____________________ Signature of First Witness
____________________ Printed Name of First Witness
____________________ Address
Second Witness
____________________ Signature of Second Witness
____________________ Printed Name of Second Witness
____________________ Address
OR
METHOD 2: Notary Public (SDCL § 34-12D-2)
Use this method if a notary public will notarize your declaration instead of two adult witnesses. Leave Method 1 blank.
State of ____________________
County of ____________________
On this the ______ day of ______________, ________, the declarant, ____________________, personally appeared before the undersigned officer and signed the foregoing instrument in my presence.
Dated this ______ day of ______________, ________.
____________________ Notary Public
My commission expires: ____________________
Legal currency, verified
This South Dakota form lets a competent adult direct life-sustaining treatment and artificial nutrition and hydration if the adult is in a terminal condition, death is imminent, and the adult cannot communicate medical decisions, under SDCL chapter 34-12D.
Tracks the sample Living Will Declaration in SDCL § 34-12D-3 (may, but need not, be used), with execution choices updated to SDCL § 34-12D-2 after SL 2023, ch 115: sign before two adult witnesses, or before a notary public. Artificial nutrition and hydration preferences are required by § 34-12D-2. Verified August 2026 against the South Dakota Legislature codified laws. It is not a government publication.
Sign the declaration yourself, or have another person sign at your direction. Then choose one method under SDCL § 34-12D-2: two adult witnesses, or a notary public. Both methods are not required. Chapter 34-12D does not list relative or provider witness disqualifications.
The statutory sample living will instructions, life-sustaining treatment initial elections, artificial nutrition and hydration initial elections, declarant signature block, Method 1 two-witness execution, and Method 2 notary execution. A completed sample PDF is available separately as a filled-in reference.
Editable Word and true fillable PDF of the complete South Dakota living will declaration. Customer support and lifetime update access are included with your purchase. This packet does not include a separate South Dakota health care power of attorney.
This form is not legal advice. Consider speaking with a South Dakota licensed attorney about your situation.
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. This packet tracks the sample Living Will Declaration in SDCL § 34-12D-3. That sample may, but need not, be used. Execution follows SDCL § 34-12D-2 as amended by SL 2023, ch 115. Verified in August 2026 against the South Dakota Legislature codified laws. It is not a government publication.
You sign the declaration, or another person may sign at your direction. Then choose one method under SDCL § 34-12D-2: two adult witnesses, or a notary public. Both methods are not required.
Chapter 34-12D requires two adults and does not list relative, heir, or health care provider disqualifications for living will witnesses. Follow the form instructions and consider local practice if you have questions.
SDCL § 34-12D-2 says a declaration must state your preferences about providing, withholding, or withdrawing artificial nutrition and hydration. If that section is left blank, South Dakota law that applies without a declaration governs those decisions.
SDCL § 34-12D-10 can limit how a declaration operates during pregnancy. That rule applies by statute even if the form does not reprint it. Ask a South Dakota licensed attorney if this matters for your situation.
Both contain the same South Dakota living will declaration text. Use the editable Word file to type details, or the fillable PDF to complete fields on screen. Print the finished document, wet-initial your elections, and sign on paper with two adult witnesses or a notary.