MAKE YOUR FREE Georgia Living Will
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What is a Georgia Living Will?
The individual making a Living Will is known as the "principal," and the person or entity gaining permission to carry out the principal's wishes is called the "agent." Suitable for residents of Georgia, this free Living Will can be used in Cobb County, Fulton County, Gwinnett County, and in all other parts of the state. Any Georgia Living Will form from Rocket Lawyer can be tailored for your specific circumstances. As a result of having this official legal document, your medical providers will have a record of your decisions, and your representative can provide confirmation that they have the authority to act in your interest when you are not able.
When to use a Georgia Living Will:
- You're about to draft a comprehensive estate plan.
- You just want to state your end-of-life wishes in writing in case you're ever unable to.
Sample Georgia Living Will
The terms in your document will update based on the information you provide
Georgia Advance Directive for Health Care
By: | Date of Birth: |
This advance directive for health care has four parts:
PART ONE-Health Care Agent. This part allows you to choose someone to make health care decisions for you when you cannot (or do not want to) make health care decisions for yourself. The person you choose is called a health care agent. You may also have your health care agent make decisions for you after your death with respect to an autopsy, organ donation, body donation, and final disposition of your body. You should talk to your health care agent about this important role.
PART TWO-Treatment Preferences. This part allows you to state your treatment preferences if you have a terminal condition or if you are in a state of permanent unconsciousness. PART TWO will become effective only if you are unable to communicate your treatment preferences. Reasonable and appropriate efforts will be made to communicate with you about your treatment preferences before PART TWO becomes effective. You should talk to your family and others close to you about your treatment preferences.
PART THREE-Guardianship. This part allows you to nominate a person to be your guardian should one ever be needed.
PART FOUR-Effectiveness and Signatures. This part requires your signature and the signatures of two witnesses. You must complete PART FOUR if you have filled out any other part of this form.
You may fill out any or all of the first three parts listed above. You must fill out PART FOUR of this form in order for this form to be effective.
You should give a copy of this completed form to people who might need it, such as your health care agent, your family, and your physician. Keep a copy of this completed form at home in a place where it can easily be found if it is needed. Review this completed form periodically to make sure it still reflects your preferences. If your preferences change, complete a new advance directive for health care.
Using this form of advance directive for health care is completely optional. Other forms of advance directives for health care may be used in Georgia.
You may revoke this completed form at any time. This completed form will replace any advance directive for health care, durable power of attorney for health care, health care proxy, or living will that you have completed before completing this form.
PART ONE-Health Care Agent
PART ONE will be effective even if PART TWO is not completed. A physician or health care provider who is directly involved in your health care may not serve as your health care agent. If you are married, a future divorce or annulment of your marriage will revoke the selection of your current spouse as your health care agent. If you are not married, a future marriage will revoke the selection of your health care agent unless the person you selected as your health care agent is your new spouse.
1. Health Care Agent
I select the following person as my health care agent to make health care decisions for me:
Name:
Address: , ,
Telephone Numbers: ,
2. Back-Up Health Care Agent
This section is optional. PART ONE will be effective even if this section is left blank.
If my health care agent cannot be contacted in a reasonable time period and cannot be located with reasonable efforts or for any reason my health care agent is unavailable or unable or unwilling to act as my health care agent, then I select the following, each to act successively in the order named, as my back-up health care agent(s):
3. General Powers of Health Care Agent
My health care agent will make health care decisions for me when I am unable to communicate my health care decisions or I choose to have my health care agent communicate my health care decisions.
My health care agent will have the same authority to make any health care decision that I could make. My health care agent's authority includes, for example, the power to:
- | Admit me to or discharge me from any hospital, skilled nursing facility, hospice, or other health care facility or service; |
- | Request, consent to, withhold, or withdraw any type of health care; and |
- | Contract for any health care facility or service for me, and to obligate me to pay for these services (and my health care agent, acting in this official capacity, will not be financially liable for any services or care contracted for me or on my behalf). |
My health care agent will be my personal representative for all purposes of federal or state law related to privacy of medical records (including the Health Insurance Portability and Accountability Act of 1996) and will have the same access to my medical records that I have and can disclose the contents of my medical records to others for my ongoing health care.
My health care agent may accompany me in an ambulance or air ambulance if in the opinion of the ambulance personnel protocol permits a passenger and my health care agent may visit or consult with me in person while I am in a hospital, skilled nursing facility, hospice, or other health care facility or service if its protocol permits visitation.
My health care agent may present a copy of this advance directive for health care in lieu of the original and the copy will have the same meaning and effect as the original.
I understand that under Georgia law:
- | My health care agent may refuse to act as my health care agent; |
- | A court can take away the powers of my health care agent if it finds that my health care agent is not acting properly; and |
- | My health care agent does not have the power to make health care decisions for me regarding psychosurgery, sterilization, or treatment or involuntary hospitalization for mental or emotional illness, mental retardation, or addictive disease. |
- | An agent can bind the declarant to pay, but Georgia law does not expressly mention binding the estate of the declarant. |
I hereby agree that my agent has the authority to bind both myself personally as well as my estate to pay for necessary medical treatment.
4. Guidance for Health Care Agent
When making health care decisions for me, my health care agent should think about what action would be consistent with past conversations we have had, my treatment preferences as expressed in PART TWO (if I have filled out PART TWO), my religious and other beliefs and values, and how I have handled medical and other important issues in the past. If what I would decide is still unclear, then my health care agent should make decisions for me that my health care agent believes are in my best interest, considering the benefits, burdens, and risks of my current circumstances and treatment options.
5. Powers of Health Care Agent After Death
(A) AUTOPSY
My health care agent will have the power to authorize an autopsy of my body unless I have limited my health care agent's power by initialing below.
_________ (Initials) | My health care agent will not have the power to authorize an autopsy of my body (unless an autopsy is required by law). |
(B) ORGAN DONATION AND DONATION OF BODY
My health care agent will have the power to make a disposition of any part or all of my body for medical purposes pursuant to the Georgia Anatomical Gift Act, unless I have limited my health care agent's power by initialing below.
Initial each statement that you want to apply.
_________ (Initials) | My health care agent will not have the power to make a disposition of my body for use in a medical study program. |
_________ (Initials) | My health care agent will not have the power to donate any of my organs. |
(C) FINAL DISPOSITION OF BODY
My health care agent will have the power to make decisions about the final disposition of my body unless I have initialed below.
_________ (Initials) | I want the following person to make decisions about the final disposition of my body: |
I wish for my body to be:
_________ (Initials) | Buried |
OR
_________ (Initials) | Cremated |
PART TWO-Treatment Preferences
PART TWO will be effective only if you are unable to communicate your treatment preferences after reasonable and appropriate efforts have been made to communicate with you about your treatment preferences. PART TWO will be effective even if PART ONE is not completed. If you have not selected a health care agent in PART ONE, or if your health care agent is not available, then PART TWO will provide your physician and other health care providers with your treatment preferences. If you have selected a health care agent in PART ONE, then your health care agent will have the authority to make all health care decisions for you regarding matters covered by PART TWO. Your health care agent will be guided by your treatment preferences and other factors described in Section (4) of PART ONE.
6. Conditions
PART TWO will be effective if I am in any of the following conditions:
Initial each condition in which you want PART TWO to be effective.
_________ (Initials) | A terminal condition, which means I have an incurable or irreversible condition that will result in my death in a relatively short period of time. |
_________ (Initials) | A state of permanent unconsciousness, which means I am in an incurable or irreversible condition in which I am not aware of myself or my environment and I show no behavioral response to my environment. |
My condition will be determined in writing after personal examination by my attending physician and a second physician in accordance with currently accepted medical standards.
7. Treatment Preferences
State your treatment preference by initialing (A), (B), or (C). If you choose (C), state your additional treatment preferences by initialing one or more of the statements following (C). You may provide additional instructions about your treatment preferences in the next section. You will be provided with comfort care, including pain relief, but you may also want to state your specific preferences regarding pain relief in the next section.
If I am in any condition that I initialed in Section (6) above and I can no longer communicate my treatment preferences after reasonable and appropriate efforts have been made to communicate with me about my treatment preferences, then:
_________ (Initials) | Try to extend my life for as long as possible, using all medications, machines, or other medical procedures that in reasonable medical judgment could keep me alive. If I am unable to take nutrition or fluids by mouth, then I want to receive nutrition or fluids by tube or other medical means. |
OR
(B) | _________ (Initials) | Allow my natural death to occur. I do not want any medications, machines, or other medical procedures that in reasonable medical judgment could keep me alive but cannot cure me. I do not want to receive nutrition or fluids by tube or other medical means except as needed to provide pain medication. |
OR
(C) | _________ (Initials) | I do not want any medications, machines, or other medical procedures that in reasonable medical judgment could keep me alive but cannot cure me, except as follows: |
Initial each statement that you want to apply to option (C).
_________ (Initials) | If I am unable to take nutrition by mouth, I want to receive nutrition by tube or other medical means. |
_________ (Initials) | If I am unable to take fluids by mouth, I want to receive fluids by tube or other medical means. |
_________ (Initials) | If I need assistance to breathe, I want to have a ventilator used. |
_________ (Initials) | If my heart or pulse has stopped, I want to have cardiopulmonary resuscitation (CPR) used. |
8. Additional Statements
This section is optional. PART TWO will be effective even if this section is left blank. This section allows you to state additional treatment preferences, to provide additional guidance to your health care agent (if you have selected a health care agent in PART ONE), or to provide information about your personal and religious values about your medical treatment. For example, you may want to state your treatment preferences regarding medications to fight infection, surgery, amputation, blood transfusion, or kidney dialysis. Understanding that you cannot foresee everything that could happen to you after you can no longer communicate your treatment preferences, you may want to provide guidance to your health care agent (if you have selected a health care agent in PART ONE) about following your treatment preferences. You may want to state your specific preferences regarding pain relief.
I do not wish to include any additional preferences.
9. In Case of Pregnancy
PART TWO will be effective even if this section is left blank.
I understand that under Georgia law, PART TWO generally will have no force and effect if I am pregnant unless the fetus is not viable and I indicate by initialing below that I want PART TWO to be carried out.
_________ (Initials) | I want PART TWO to be carried out if my fetus is not viable. |
PART THREE-Guardianship
10. Guardianship
PART THREE is optional. This advance directive for health care will be effective even if PART THREE is left blank. If you wish to nominate a person to be your guardian in the event a court decides that a guardian should be appointed, complete PART THREE. A court will appoint a guardian for you if the court finds that you are not able to make significant responsible decisions for yourself regarding your personal support, safety, or welfare. A court will appoint the person nominated by you if the court finds that the appointment will serve your best interest and welfare. If you have selected a health care agent in PART ONE, you may (but are not required to) nominate the same person to be your guardian. If your health care agent and guardian are not the same person, your health care agent will have priority over your guardian in making your health care decisions, unless a court determines otherwise.
State your preference by initialing (A) or (B). Choose (A) only if you have also completed PART ONE.
(A) | _________ (Initials) | I nominate the person serving as my health care agent under PART ONE to serve as my guardian. |
OR
(B) | _________ (Initials) | I nominate the following person to serve as my guardian: |
PART FOUR-Effectiveness and Signatures
This advance directive for health care will become effective only if I am unable or choose not to make or communicate my own health care decisions.
This form revokes any advance directive for health care, durable power of attorney for health care, health care proxy, or living will that I have completed before this date.
Unless I have initialed below and have provided alternative future dates or events, this advance directive for health care will become effective at the time I sign it and will remain effective until my death (and after my death to the extent authorized in Section (5) of PART ONE).
_________ (Initials) | This advance directive for health care will become effective on or upon and will terminate on or upon . |
This Georgia Advance Directive for Health Care may be revoked at any time, regardless of the declarant's mental state or competency. It remains effective even if a Guardian is appointed for the declarant, unless a court specifically orders otherwise.
I understand that revocation may occur in any of the following ways:
--By completing a new Advance Directive for Health Care
--By burning, tearing up, or otherwise destroying the existing Advance Directive for Health Care
--By orally expressing intent to revoke the Advance Directive for Health Care in the presence of a witness 18 years of age or older who confirms this in writing within 30 days. The revocation is effective when the treating physcian documents it in the medical record.
--Marrying after executing an Advance Directive for Health Care revokes any agent other than the declarant's spouse.
--Divorcing or otherwise dissolving a marriage after the execution of an Advance Directive for Health Care revokes the designation of the spouse as the health care agent.
This document may be signed by you or signed by someone else in your presence and at your express direction.
You must sign and date or acknowledge signing and dating this form in the presence of two witnesses. Both witnesses must be of sound mind and must be at least 18 years of age, but the witnesses do not have to be together or present with you when you sign this form.
A witness:
- | Cannot be a person who was selected to be your health care agent or back-up health care agent in PART ONE; |
- | Cannot be a person who will knowingly inherit anything from you or otherwise knowingly gain a financial benefit from your death; or |
- | Cannot be a person who is directly involved in your health care. |
Only one of the witnesses may be an employee, agent, or medical staff member of the hospital, skilled nursing facility, hospice, or other health care facility in which you are receiving health care (but this witness cannot be directly involved in your health care).
A physician or health care provider directly involved in the care of the declarant may not serve as health care agent.
By signing below, I state that I am emotionally and mentally capable of making this advance directive for health care and that I understand its purpose and effect.
__________________________________________ | __________________________ |
Date |
County, Georgia
The declarant signed this form in my presence or acknowledged signing this form to me. Based upon my personal observation, the declarant appeared to be emotionally and mentally capable of making this advance directive for health care and signed this form willingly and voluntarily.
__________________________________________ | __________________________ |
(Signature of First Witness) | Date |
Print Name:
Address:, ,
__________________________________________ | __________________________ |
(Signature of Second Witness) | Date |
Print Name:
Address:, ,
Georgia Living Will FAQs
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How do I write a Living Will in Georgia?
It is fast and simple to outline your medical wishes using a free Georgia Living Will template from Rocket Lawyer:
- Make your Living Will - Provide a few details,, and we will do the rest
- Send or share it - Look over it with your healthcare agent or seek legal advice
- Sign it - Optional or not, witnesses/notarization are ideal
This route, in many cases, would end up being notably less expensive and less time-consuming than hiring the average provider. If necessary, you may start a Living Will on behalf of an elderly parent, a spouse, or another family member, and then have them sign it once you've drafted it. Keep in mind that for this document to be considered legally valid, the principal must be an adult who is mentally competent at the time of signing. If the principal is already unable to make their own decisions, a court-appointed conservatorship may be necessary. In this situation, it's important for you to speak to a lawyer .
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Why should I write a Living Will?
Anyone who is over 18 years old ought to have a Living Will. Though it can be difficult to think about, there might come a time when you are not able to make your own healthcare decisions. Here are a few common situations where you might consider it useful to make or update your Living Will:
- You've been given a terminal diagnosis
- You will be hospitalized for a medical procedure
- You are planning to move into an adult care facility
- You are aging or have declining health
Whether your Georgia Living Will has been drafted as part of a forward-looking plan or made in response to a recent change in your health, notarization and witnesses are strongly recommended as a best practice for protecting your document if its legitimacy is questioned by a third party. Please note that in Georgia, if the principal is pregnant, the Living Will is not valid.
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Should I hire an attorney for my Living Will in Georgia?
Making a Living Will is usually easy to do, but you or your agent(s) may have legal questions. Getting someone to double-check your Living Will can take a long time if you attempt to do it on your own. Another approach worth consideration is to go through the Rocket Lawyer On Call® network. Premium members are able to ask for a document review from an experienced attorney or send additional legal questions. As always, you can live confidently with Rocket Lawyer by your side.
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On average, what would it normally cost me to make a Living Will in Georgia?
The fees associated with meeting and hiring your average legal provider to draft a Living Will could total anywhere from $200 to $1,000, depending on where you are located. Rocket Lawyer offers much more than many other Living Will template websites that you may discover elsewhere. As a Rocket Lawyer member, you can get up to a 40% discount when hiring an attorney.
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Will I need to do anything else once I make a Georgia Living Will?
Attached to each Georgia Living Will form, there will be a set of instructions on what to do next. You also can take any of these actions with your document: editing it, downloading it as a PDF document or Word file, and signing it. Finally, you should be sure that your agent(s) and care providers get a copy of your fully executed document.
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Does a Living Will need to be notarized or witnessed in Georgia?
The requirements and restrictions governing Living Wills vary in each state; however, in Georgia, your Living Will must be signed by two witnesses. Witnesses cannot be anyone who is directly involved in your health care. Heirs and beneficiaries are excluded, as well. As a general principle, your witnesses will need to be at least 18 years old, and no witness should simultaneously be named as your healthcare agent.