Vermont Advance Directive Form

Overview: The Vermont Living Will is called "End of Life Treatment Wishes" and is included in an Advance Directive packet that also contains a form for naming a "Health Care Agent" (a.k.a. Health Care Proxy) and specifying Organ and Tissue Donation.

Required Information: You and two (2) witnesses must sign your VT Advance Directive for it to be considered valid. NEITHER witness can be your spouse, agent, brother, sister, child, grandchild or reciprocal beneficiary. If you are in a hospital, nursing home or residential care facility when you complete your VT Advance Directive, you will need a THIRD PERSON'S signature to certify that he or she has explained the Advance Directive to you and that you understand the impact and effect of what you are doing. In a Healthcare facility, this third person may be a hospital designee, a long-term care ombudsman, an attorney licensed to practice in Vermont, a clergyperson or a Probate Court designee BUT IS NOT affiliated with or employed by the health care facility.

Download the Vermont Advance Directive Form Here
(Via Vermont Department of Health)

Remember to add your completed form to your Everplan!

See our complete list of resources for Vermont.