Free Vermont Advance Directive & Living Will

Build a complete Vermont advance directive in minutes — free, no account. Name a health care agent, record your end-of-life wishes, and download a ready-to-sign PDF with Vermont's correct signing requirements.

A free directive — not legal or medical advice.

This builds a Vermont advance directive: it names a health care agent to decide for you and records your end-of-life wishes. It works only when you sign it as Vermont requires (see the signing steps). RecordingLaw.com is not a law firm.

About you

Your health care agent

The person who will make medical decisions if you can't speak for yourself — the most important choice.

Note: in Vermont, your agent cannot be The principal's health care provider may not be the agent. Unless related by blood, marriage, civil union, or adoption, the agent may not be an owner, operator, employee, agent, or contractor of a residential care facility, health care facility, or correctional facility in which the principal resides at execution.

Your end-of-life wishes

If you are terminally ill or permanently unconscious with no recovery expected.

If I am dying and will not recover, I want:

Other wishes (optional)

Before you sign — Vermont notes

This directive has NO legal effect until you sign it. To make it valid in Vermont: Any competent adult may make an advance directive. Date it, sign it (or have someone sign in your presence at your direction), and have two or more adult (18+) witnesses sign and affirm you understood the document and were free of duress. The agent and your close relatives (spouse, parent, adult sibling/child/grandchild) cannot be witnesses. No notary and no pregnancy exclusion.

Witness rules: a witness must NOT be Signed by two or more witnesses at least 18 years old, who affirm the principal appeared to understand the document and to be free from duress/undue influence. A witness may NOT be the agent appointed by the principal, nor the principal's spouse, parent, adult sibling, adult child, or adult grandchild. If the principal is being admitted to or is a resident/patient of a nursing home, residential care facility, or hospital at execution, the person who explained the directive may serve as one witness (special facility rule).

Your agent cannot be The principal's health care provider may not be the agent. Unless related by blood, marriage, civil union, or adoption, the agent may not be an owner, operator, employee, agent, or contractor of a residential care facility, health care facility, or correctional facility in which the principal resides at execution.

After signing, give copies to your agent, your alternate, and your doctor, and keep the original somewhere accessible. An advance directive is not filed with a court.

This is a general-purpose directive and is not legal or medical advice. For complex wishes, a serious illness, or detailed treatment limits, talk to your doctor and an estate-planning attorney. RecordingLaw.com is not a law firm.

Enter your name and your agent's name to download.

Or email yourself a copy (PDF)

Advance Health Care Directive of [YOUR FULL NAME]

PART I — DECLARATION

I, [YOUR FULL NAME], of [CITY], Vermont, being of sound mind, make this Advance Health Care Directive to state my wishes for my medical care and to appoint a person to make health care decisions for me if I cannot make them myself. I revoke any prior advance directive, living will, or health care power of attorney I have made.

PART II — MY HEALTH CARE AGENT

I appoint [AGENT NAME] as my health care agent.

My agent's authority takes effect when my attending physician determines that I am unable to make my own health care decisions, and ends if I regain that ability.

My agent may make any health care decision I could make, including consenting to, refusing, or withdrawing any medical care, treatment, or procedure; choosing and changing my doctors and care facilities; and arranging for my comfort and pain relief. My agent must follow my wishes as stated in this document and otherwise act in my best interest.

I authorize my agent to obtain and review my medical information, and I make my agent my personal representative under the Health Insurance Portability and Accountability Act (HIPAA) for that purpose.

PART III — LIVING WILL — MY END-OF-LIFE WISHES

If I am terminally ill, permanently unconscious, or in an end-stage condition with no reasonable expectation of recovery, I do NOT want life-sustaining treatment (such as CPR, a ventilator, or dialysis) that would only prolong the process of dying. I direct that such treatment be withheld or withdrawn and that I be allowed to die naturally, receiving only care for my comfort.

I do NOT want artificially administered nutrition and hydration if it would serve only to prolong the process of dying.

Regardless of my other choices, I always want to be kept as comfortable and free of pain as possible, even if medication to relieve my pain may hasten my death.

PART IV — GENERAL PROVISIONS

This directive is governed by the laws of Vermont and is intended to be effective in any place where I may be. A copy of this directive has the same effect as the original. I may revoke it at any time by notifying my agent or health care provider, orally or in writing.

If any part of this directive is held invalid, the rest remains in effect. My health care providers and agent who act in good faith reliance on this directive are protected to the fullest extent of the law.

SIGNATURE

I sign this Advance Health Care Directive willingly, on this _____ day of ____________, 20____, at [CITY], Vermont.

____________________________________

[YOUR FULL NAME], Principal

WITNESSES — Each of us declares that the principal signed this directive in our presence, appeared to be of sound mind and free from duress, that we are each at least 18 years old, and that we are not disqualified from witnessing under this state's law (see the signing instructions for who may not witness).

Witness 1: ____________________________ Address: ____________________________

Witness 2: ____________________________ Address: ____________________________

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