ADVANCE DIRECTIVE & DISPOSITION OF REMAINS DECLARATION

This attorney-style template allows you to document your medical, mental health, and end-of-life care preferences, as well as instructions for organ donation and the disposition of your remains.

It includes:

• Health Care Agent designation with alternates
• Choices for life support, nutrition, hydration, and comfort care
• Organ and tissue donation options
• Burial, cremation, and custom remains instructions
• Mental health treatment preferences (medications, ECT, hospitalization)
• Memorial, funeral, and cultural/religious directives
• Payment of expenses clause with estate/insurance fallback
• Witness and notary acknowledgment sections for legal validity

Format: Fillable PDF (print or complete digitally)

Use Cases: Health care planning, end-of-life directives, estate planning

Notarization: Notary certificate included (optional, but recommended in many states)

⚠️ Disclaimer:

This is a general-use form. Laws vary by state. Consult an attorney to ensure compliance with your state’s requirements. Utsey Notary Services LLC does not provide legal advice.

Instructions:

Download instantly after purchase, complete the form, and have it notarized by Utsey Notary Services or any licensed notary of your choice before submitting it to your insurance company.