Overview
This link will take you to a page on the AARP website where you can find links to forms for each state of the US. In some cases you must use that state's form — in others it is not required (ask a local attorney). You should be aware that it appears a group called The National Hospice and Palliative Care Organization at www.caringinfo.org took the forms from each state's resources and added other information around the forms.
A cross-check indicates this group may have also slightly changed wording in these forms. Thus, you may want to go directly to the online statutes for your state and find the form itself. Also, AARP and the CaringInfo group come from a very medical frame of reference. Thus, you have to wade through medical materials, recommendations to get "your physician" to assist you, and more to find the basic elements that are helpful to creating this legal document.