Connecticut Advance Directive Forms

An advance directive is a legally binding document that gives instructions for your healthcare in the event that you are no longer able to make or communicate those decisions yourself. Laws and instructions differ by state. Learn more about the basics of advance directives and advance care planning.

Below you will find the advance directive template for Connecticut.

Instructions for Downloading the Advance Directive Template

• Opening a PDF requires a file viewer such as Adobe Acrobat Reader or MacOS Preview.
• If you already have this software installed on your computer, click on your state to proceed.
• Due to formatting and printing requirements, for some states a blank page will appear in the Acrobat Reader as the first page. This does not mean the document has not loaded correctly.
• Use the reader’s navigational toolbar to go to the next page.
• Once completed, save and print the form, or store it digitally. If using paper, you should scan the form and save it everywhere you can – including your phone – and distribute them to your inner circle, your physician, and anyone else you think should have it.

What happens if you do not have an Advance Directive in Connecticut and are unable to speak for yourself

State law protects a physician, advanced practice RN (APRN) or medical facility that withholds life-sustaining treatment, if

1. the decision to withhold is based on best medical judgment,
2. the physician or APRN determines the patient is in a terminal condition or permanently unconscious, and
3. the attending physician or APRN has considered wishes expressed in an advance directive, or, if not, consulting any other statement made by the patient and, if available, the patient’s healthcare representative, next of kin, a legal guardian or conservator, or others designated by the patient or with whom the patient has communicated his or her wishes.

CT 19a-570 defines “next of kin” as the following classes of persons, in order of priority

1. Spouse
2. Adult son or daughter
3. Either parent
4. An adult brother or sister
5. A grandparent.

CT Gen Stat §§19a-570 & 571

Note that in many states, there are separate requirements related to minors, specific types of treatment (such as mental healthcare or medical research), or for pregnant women. These more specific provisions are beyond the scope of this information. Some states will also allow for an oral designation of an agent. The purpose of this information is to help you plan ahead for when you may not be able to make a decision for yourself, so it does not address oral designations.