The declaration may be substantially in the following form, but not to the exclusion of other written and clear expressions of intent to accept, refuse, or withdraw medical care:

Terms Used In Tennessee Code 32-11-105

  • Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
  • Declarant: means an individual who declares a living will under this chapter. See Tennessee Code 32-11-103
  • health facility: means a person, facility or institution licensed or authorized to provide health or medical care. See Tennessee Code 32-11-103
  • Living will: means a written declaration, pursuant to this chapter, stating declarant's desires for medical care or noncare, including palliative care, and other related matters such as organ donation and body disposal. See Tennessee Code 32-11-103
  • Medical care: includes any procedure or treatment rendered by a physician or health care provider designed to diagnose, assess or treat a disease, illness or injury. See Tennessee Code 32-11-103
  • Physician: means any person licensed or permitted to practice medical care under title Tennessee Code 32-11-103
  • State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
  • Terminal condition: means any disease, illness, injury or condition, including, but not limited to, a coma or persistent vegetative state, sustained by any human being, from which there is no reasonable medical expectation of recovery and that, as a medical probability, will result in the death of the human being, regardless of the use or discontinuance of medical treatment implemented for the purpose of sustaining life, or the life processes. See Tennessee Code 32-11-103
  • written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105

Click to view form.

[Acts 1985, ch. 355, § 5; 1991, ch. 344, § 6.]