Homepage Fillable Living Will Template for New Hampshire
Outline

In the scenic state of New Hampshire, individuals are given the power to make critical decisions regarding their healthcare through the implementation of a Living Will form. This essential document serves as a beacon of autonomy, enabling persons to outline their medical preferences should they become unable to communicate their wishes directly due to severe illness or incapacitation. The form meticulously addresses various medical scenarios, including the use of life-sustaining treatments and end-of-life care, ensuring that a person's healthcare choices are respected and adhered to. Not only does it provide a structured way for individuals to express their desires concerning medical interventions, but it also significantly alleviates the emotional and decision-making burden on loved ones and healthcare providers. Furthermore, the New Hampshire Living Will form, guided by state-specific statutes, encompasses legal mandates that safeguard its validity and enforceability, thereby granting peace of mind to those who take this thoughtful step toward future healthcare planning. Through the precision and foresight offered by this document, residents of New Hampshire can confidently assert control over their medical circumstances, embodying a proactive approach to life's most challenging moments.

Document Sample

New Hampshire Living Will Template

This Living Will is designed in accordance with the New Hampshire Advance Directives Laws. It is intended to express the preferences concerning medical treatment or non-treatment by the signatory in the event that they are no longer able to communicate their medical decisions due to incapacity.

Personal Information

Full Name: ________________________________________________________

Date of Birth: ________________________

Address: __________________________________________________________

City: ________________________ State: NH Zip Code: _________________

Directive Statement

I, ____________ [Your Full Name], being of sound mind, hereby direct that my health care providers and others involved in my care follow the instructions provided in this document regarding my health care and treatment. Should I be in a state whereby I can no longer make my own health care decisions, the wishes expressed here shall guide my care.

Life-Sustaining Treatment Preferences

In the event that I am in a terminal condition, permanently unconscious, or in another condition in which I am unable to communicate my desires for treatment, I request the following actions to be taken:

  1. Administration of treatment to alleviate pain or discomfort, even if it does not prolong life, unless specified otherwise below.
  2. Withholding or withdrawal of life-sustaining treatments that only prolong the process of dying or are unlikely to result in significant recovery.
  3. Withholding of food and water if the provision of such is deemed life-sustaining treatment and I have indicated a desire to have it withheld.

Specific Instructions: _____________________________________________

___________________________________________________________________

Designation of Health Care Agent

I designate the following individual as my health care agent to make medical decisions for me when I am unable to do so. This person shall have the same authority to request or refuse treatment on my behalf as I would have if capable of making and communicating decisions.

Agent's Full Name: _________________________________________________

Relationship to Signatory: __________________________________________

Agent's Phone Number: ______________________________________________

Alternate Agent's Full Name: ________________________________________

Relationship to Signatory: __________________________________________

Alternate Agent's Phone Number: _____________________________________

Signatures

This document is executed this _____ day of ____________, 20____, in the presence of the undersigned witnesses, by ____________ [Your Full Name], the principal.

Principal's Signature: _____________________________________________

Date: _____________________________________________________________

Witness 1 Signature: _______________________________________________

Print Name: ________________________________________________________

Witness 2 Signature: _______________________________________________

Print Name: ________________________________________________________

This Living Will becomes effective only upon my incapacity to participate in health care decisions. It affirms my right to accept or refuse medical treatment and is valid throughout New Hampshire.

Notice to Health Care Providers

Health care providers shall to the extent possible, make reasonable efforts to consult with my health care agent before implementing decisions related to my health care. This document revokes all prior advance directives and represents my current wishes regarding my health care.

PDF Form Breakdown

Fact Number Fact Detail
1 New Hampshire's living will is officially known as an "Advance Directive".
2 It allows individuals to outline their healthcare wishes in the event they become incapacitated.
3 This form is governed by RSA 137-J of the New Hampshire Revised Statutes.
4 The document can include decisions about life-sustaining treatments and end-of-life care.
5 Residents have the option to appoint a healthcare agent to make decisions on their behalf.
6 A living will becomes effective only when a person cannot communicate their healthcare decisions.
7 To be legally binding, the document must be signed in the presence of two witnesses or a notary public.
8 Witnesses to the document cannot be the person's healthcare provider or an employee of a healthcare facility where the signer is a patient.
9 New Hampshire residents can revoke or amend their living will at any time.
10 The state does not require the document to be filed with any government agency; it should be kept in a safe place where it is easily accessible.
This table outlines ten important facts about the New Hampshire Living Will form, giving individuals a broad overview of its significance and how it operates within the state's legal framework.

How to Use New Hampshire Living Will

When you're ready to take the important step of planning for your future healthcare, a Living Will is a legal document you'll need in New Hampshire. This document allows you to outline your wishes for medical treatment if you're unable to communicate them yourself. Filling out a Living Will can seem daunting, but following these step-by-step instructions can make the process clearer and more manageable. This ensures your healthcare preferences are respected, even in situations where you cannot voice them directly.

  1. Start by locating a copy of the New Hampshire Living Will form. You can usually find this document online through the New Hampshire Department of Health and Human Services or by asking a lawyer for assistance.
  2. Read the form carefully before you begin filling it out. Understanding each section will help you make informed decisions about your healthcare preferences.
  3. Enter your full legal name and date of birth at the top of the form, ensuring that all your information is accurate and clearly legible.
  4. In the sections that ask about your treatment preferences, clearly indicate which medical interventions you want or do not want. This may include decisions about life support, resuscitation, and artificial nutrition and hydration.
  5. If the form provides space for additional instructions, use this area to detail any other healthcare wishes you have that might not be explicitly covered in the form's checkboxes or prompts.
  6. Designate a healthcare agent by filling in the name, relationship, and contact information of the person you trust to make healthcare decisions on your behalf if you are unable to do so. Make sure to discuss this role with them beforehand to ensure they are willing and able to take on this responsibility.
  7. Review your completed Living Will form to make sure all the information is correct and reflects your wishes accurately. Make any necessary changes before proceeding to the next step.
  8. Sign and date the form in the presence of two witnesses. The witnesses must also sign and date the form, attesting that you are voluntarily making these decisions and are of sound mind. Some portions of the Living Will might also require notarization, so check the requirements specific to New Hampshire and arrange for a notary public if necessary.
  9. Keep the original signed copy of your Living Will in a safe but accessible place. Give copies to your healthcare agent, family members, and your primary care physician to ensure your wishes are known and can be easily accessed when needed.
  10. Lastly, remember to review and update your Living Will periodically, especially after significant life changes like a marriage, divorce, the birth of a child, or a change in your health status. This keeps the document relevant and aligned with your current wishes.

Completing a Living Will is a proactive step in managing your healthcare preferences. By clearly documenting your wishes, you provide guidance to your loved ones and healthcare providers, removing the guesswork and ensuring your healthcare decisions are respected, no matter what the future holds.

Understanding New Hampshire Living Will

What is a New Hampshire Living Will?

A Living Will in New Hampshire is a legal document that outlines your wishes regarding medical treatment in instances where you cannot communicate your decisions due to illness or incapacitation. It enables you to declare your preferences on life-sustaining treatments, including resuscitation, mechanical ventilation, and artificial nutrition and hydration.

Who should have a Living Will?

Anyone over the age of 18 should consider creating a Living Will. It's especially important for those with specific wishes about their healthcare or those with a diagnosed medical condition. However, it's a useful document for anyone who wants to ensure their healthcare preferences are known and respected in case they're unable to express them.

How does one create a Living Will in New Hampshire?

To create a Living Will in New Hampshire, you must complete the Living Will form, ensuring it reflects your healthcare preferences accurately. The document must be signed in the presence of two witnesses who are not related to you, will not inherit anything from you, and are not directly responsible for your healthcare costs. Alternatively, it can be notarized.

Is a lawyer needed to create a Living Will in New Hampshire?

No, a lawyer is not required to create a Living Will in New Hampshire. However, consulting with a legal advisor who is experienced in estate planning can provide valuable guidance to ensure your Living Will accurately reflects your wishes and complies with New Hampshire law.

Can a Living Will be changed or revoked?

Yes, you can change or revoke your Living Will at any time as long as you are of sound mind. To make changes, you should create a new Living Will that clearly indicates your revised wishes and follow the same signing and witnessing procedures. To revoke the document, you can destroy the original copy, create a new document that states your intention to revoke the previous one, or verbally inform your healthcare provider of your decision.

What happens if I don’t have a Living Will?

If you don't have a Living Will and become incapacitated, healthcare decisions will be left to your family members or a court-appointed guardian. This can lead to uncertainty and disputes among family members about what you might have wanted. Having a Living Will removes this burden from your loved kernelly by making your wishes clearly known.

Does a Living Will impact the quality of care I will receive?

No, having a Living Will does not impact the quality of medical care you receive. It solely provides guidance on how you wish to be treated in specific circumstances where you are unable to make decisions yourself. Medical professionals still have an obligation to provide the best possible care, respecting your wishes as stated in your Living Will.

Is a Living Will the same as a Durable Power of Attorney for Health Care?

No, a Living Will is not the same as a Durable Power of Attorney for Health Care. A Living Will specifically outlines your wishes regarding life-sustaining treatment, while a Durable Power of Attorney for Health Care allows you to appoint someone to make healthcare decisions on your behalf. Many people choose to have both documents to cover all aspects of their healthcare decisions.

Common mistakes

Filling out a Living Will in New Hampshire allows individuals to make their healthcare wishes known in advance, in case they are unable to communicate those wishes themselves. However, mistakes can happen during this process, leading to confusion and possibly not having one's wishes followed. Here are seven common mistakes people make when completing this essential document:

  1. Not being specific enough about medical treatments. Many people fail to provide detailed preferences for their medical care, which can leave healthcare providers and loved ones guessing in critical situations. It's key to clarify your wishes regarding life-sustaining treatments, such as ventilation and artificial nutrition.
  2. Forgetting to update the document. Life circumstances and medical preferences can change, but individuals often forget to update their Living Will accordingly. Regular reviews ensure the document reflects current wishes.
  3. Failing to discuss wishes with family and healthcare providers. Simply filling out the form isn't enough. It's crucial to discuss your preferences with those who may be involved in your healthcare decisions to avoid surprises and ensure your wishes are respected.
  4. Not having the document witnessed or notarized as required. New Hampshire law might require your Living Will to be either witnessed or notarized, or both. Failure to follow these legal formalities can invalidate the document.
  5. Overlooking the designation of a healthcare proxy. The Living Will is an opportunity to designate a healthcare agent who can make decisions on your behalf. Neglecting to appoint a trusted individual can lead to decisions being made by someone not familiar with your preferences.
  6. Using vague language. Ambiguity can lead to interpretations of the document that don't align with your actual wishes. Clear and concise language helps ensure your healthcare choices are understood as you intended.
  7. Not distributing copies of the Living Will to the right people. A Living Will is useless if nobody knows it exists or where to find it. Making sure that family members, your healthcare agent, and your primary care doctor have copies is vital for ensuring your wishes are honored.

To avoid these mistakes, individuals should take the time to complete the New Hampshire Living Will form carefully and consider seeking legal advice to ensure all aspects of the document meet legal requirements and accurately reflect their healthcare wishes. This careful attention to detail can provide peace of mind and uphold one's desires regarding medical treatment.

Documents used along the form

When individuals prepare for future medical care, particularly in New Hampshire, a Living Will form is often central to their planning. This document clearly outlines a person's wishes regarding life-prolonging medical treatments in the event they become unable to communicate their decisions due to illness or incapacity. However, to ensure comprehensive healthcare planning, other forms and documents are frequently used alongside the New Hampshire Living Will form. These additional documents cover a wide range of considerations, from appointing decision-makers to specifying preferences for post-mortem arrangements.

  • Durable Power of Attorney for Healthcare: This form allows an individual to designate another person as their agent to make healthcare decisions on their behalf if they are unable to do so themselves.
  • Do Not Resuscitate (DNR) Order: A DNR order instructs healthcare providers not to perform CPR if a person’s breathing stops or if their heart stops beating.
  • Medical Orders for Life-Sustaining Treatment (MOLST): This document provides specific instructions about certain life-sustaining treatments based on the patient's current health condition and preferences.
  • HIPAA Release Form: This form authorizes the disclosure of an individual's health information to specified persons or entities, facilitating communication between healthcare providers and designated family members or friends.
  • Organ and Tissue Donation Registration: By completing this form, individuals can register their consent to donate their organs and tissues after death.
  • Disposition of Remains Authorization: This allows individuals to outline their preferences for the disposition of their remains and specify any arrangements for funeral services or ceremonies.
  • Financial Power of Attorney: While not directly related to healthcare, this document designates another person to manage the individual's financial affairs and can be essential in ensuring that healthcare needs are funded.
  • Living Trust: A living trust helps manage an individual's assets during their lifetime and can provide for the distribution of these assets upon their death, which might include provisions for long-term healthcare.
  • Emergency Contact Information Form: This form lists individuals to be contacted in case of an emergency, including their relationship to the person and contact details.
  • Personal Medical History Form: Although not a legal document, maintaining a detailed record of medical history, allergies, medications, and past procedures can be invaluable to healthcare providers.

Together, these documents create a comprehensive framework to guide not only healthcare professionals but also family members and loved ones through the intricacies of managing an individual's healthcare preferences and final wishes. It's crucial for individuals to understand not just the importance of having a Living Will, but also the role that each of these additional documents plays in ensuring their wishes are honored and their well-being is safeguarded. Proper planning, accompanied by open communication with loved ones and healthcare providers, forms the cornerstone of effective healthcare decision-making.

Similar forms

The New Hampshire Living Will form is similar to other healthcare directives in its purpose and function, but there are specific documents it closely aligns with. These include the Medical Power of Attorney, the Durable Power of Attorney for Healthcare, and the Do Not Resuscitate (DNR) order. Each plays a key role in a person's medical and end-of-life decisions, although they differ in scope and applicability.

Medical Power of Attorney: The New Hampshire Living Will form and the Medical Power of Attorney are similar because both allow a person to make decisions about their medical care in advance. The main difference lies in their focus; the Living Will specifically addresses end-of-life treatment preferences, whereas the Medical Power of Attorney appoints someone else to make healthcare decisions on the person's behalf, not limited to end-of-life situations. This ensures that, should the person become unable to communicate their wishes, someone they trust can make decisions that align with their values and preferences.

Durable Power of Attorney for Healthcare: This document is quite similar to the Medical Power of Attorney but with a focus strictly on healthcare decisions. Like the Living Will, it comes into play when a person can no longer make decisions for themselves. The "durable" aspect signifies that the power remains in effect even if the person becomes incapacitated. The primary difference from the Living Will is its broader application, allowing the appointed agent to make decisions on a wide range of healthcare matters, not just those concerning life-sustaining treatment.

Do Not Resuscitate (DNR) Order: A DNR order and the Living Will both address a person's preferences for life-sustaining treatments, but the DNR is far more specific. It explicitly instructs healthcare providers not to perform CPR if a person's breathing or heart stops. The Living Will, on the other hand, might outline a broader range of situations and treatments it covers, including but not limited to resuscitation. Individuals who feel strongly about avoiding CPR as part of their end-of-life care often include a DNR order as part of their advance directives.

Dos and Don'ts

Filling out a New Hampshire Living Will can feel daunting, but it's an important step to ensure your healthcare preferences are respected. Properly completing this document means paying attention to details, understanding your options, and recognizing the legal implications of your decisions. To guide you through this process, here are essential dos and don'ts:

  • Do thoroughly read the entire form before you begin filling it out. Understanding the scope and purpose of each section is crucial.
  • Do consider consulting with a healthcare professional or a legal advisor if there are any parts of the form you do not fully understand. They can provide valuable insight into the implications of your choices.
  • Do be very specific about your healthcare wishes. The more detailed you are, the easier it will be for your healthcare providers and loved ones to follow your instructions.
  • Do discuss your wishes with your family and anyone else who might be involved in your care. Just like writing a Living Will, this conversation can be tough but necessary.
  • Do clearly identify your health care proxy, if you choose to appoint one. This person will make decisions on your behalf if you're unable to do so yourself, so choose someone you trust completely.
  • Don't leave any sections blank unless the form specifically instructs you to do so. Unanswered questions can lead to confusion and delays in your care.
  • Don't rush through the process. Consider your options carefully and take the time you need to make well-informed decisions.
  • Don't use ambiguous language. Your instructions should be as clear and concise as possible to avoid any possible misinterpretation.
  • Don't forget to sign and date the form in the presence of the required witnesses or a notary public, according to New Hampshire law. This step is critical to make your Living Will legally binding.
  • Don't store your Living Will in a location where it can't be easily found. Let your healthcare proxy, family, and primary doctor know where it is, and consider giving them copies.

Approaching a Living Will with the seriousness and attention it deserves can help ensure that your healthcare preferences are understood and honored. While it may not cover every possible situation, a carefully completed Living Will can provide peace of mind knowing that your wishes are documented. Remember, you can always update your Living Will should your preferences change. Taking these steps will help safeguard your autonomy and contribute to your overall wellness journey.

Misconceptions

When it comes to preparing for the future, particularly regarding health care decisions, understanding the specifics about legal forms is crucial. In New Hampshire, the Living Will is an important document that allows individuals to dictate their end-of-life care preferences. However, there are several misconceptions about the Living Will form that often lead to confusion. Here are seven common misunderstandings:

  • It’s only for the elderly. Many people think Living Wills are only necessary for older adults. However, unforeseen medical emergencies can happen at any age, making it important for adults of all ages to consider preparing a Living Will.
  • Having a Living Will means you'll receive less medical care. This is not true. A Living Will specifies your preferences regarding the types of life-sustaining treatment you do or do not want in certain situations. It's about ensuring your healthcare aligns with your wishes, not about limiting care.
  • A Living Will is the same as a Health Care Power of Attorney. While both documents pertain to medical decisions, a Living Will outlines your wishes about life-sustaining treatments, and a Health Care Power of Attorney nominates someone to make health care decisions on your behalf if you are unable to do so.
  • Once created, it cannot be changed. Actually, you can revise or revoke your Living Will at any time as long as you are competent. Life circumstances and preferences can change, and your Living Will can reflect these changes.
  • Your doctor can override your Living Will. Doctors and healthcare providers are legally bound to follow the directives in your Living Will as long as it complies with state laws. They cannot override your wishes without a legally valid reason, such as the document not being properly executed.
  • Living Wills are only effective in the state they were created in. While it's true that laws vary by state, many states have provisions to respect documents created in other states as long as they comply with the other state's laws. It's a good idea to review your Living Will if you move to ensure it is still fully effective.
  • You don’t need a lawyer to make a Living Will. While it’s advisable to consult with a legal professional to ensure your document is correctly executed and aligns with your wishes, it’s not a legal requirement. New Hampshire provides resources and guidelines to help individuals create their own Living Wills.

Understanding the realities behind these misconceptions can help you make informed decisions about your health care preferences and ensure your wishes are known and respected, no matter what the future holds.

Key takeaways

When preparing a Living Will in New Hampshire, it's crucial to ensure that the document reflects your healthcare preferences accurately. This is essential for guiding your loved ones and healthcare providers if you cannot make decisions for yourself. Here are key takeaways to consider:

  • Understanding the purpose of the Living Will is fundamental. It serves as a legally binding document that records your wishes regarding medical treatment in scenarios where you're unable to communicate due to serious illness or incapacitation.
  • Completeness and accuracy are non-negotiable. Make certain every section of the form is filled out without leaving any ambiguities. This clarity will prevent potential confusion or disputes among family members or medical personnel regarding your care.
  • Consider consulting with a healthcare professional. They can offer insights into medical terms and treatment options mentioned in the form, helping you make informed decisions about your end-of-life care.
  • Legal advice might be beneficial. Although not always necessary, consulting with an attorney can ensure that your Living Will complies with New Hampshire's specific laws and regulations, safeguarding its validity.
  • Witness requirements must be strictly followed. New Hampshire law requires the signature of witnesses to validate your Living Will. These witnesses cannot be beneficiaries or have a vested interest in your estate, ensuring unbiased confirmation of your wishes.
  • Make copies and inform key people. Once your Living Will is completed, make several copies. Give one to your primary care physician, a trusted family member, and your healthcare proxy if you have designated one.
  • Review and update periodically. As your health status or preferences change, so might your end-of-life wishes. Regularly reviewing and updating your Living Will ensures it always reflects your current desires. Changes must be made formally, adhering to the same process as the original document preparation.

By keeping these takeaways in mind, you can effectively communicate your healthcare preferences, providing peace of mind for yourself and your loved ones.

Please rate Fillable Living Will Template for New Hampshire Form
4.69
Bullseye
169 Votes