Living Will Blank Form

July 21, 2011

Living wills are legal instruments that are used to make one’s wishes about treatment known. The medical treatment is typically life prolonging and it is described in detail in the living will. The maker of the will indicates the type of treatment that he or she deems acceptable or unacceptable.

Sample Living Will Blank Form

I   ………………………………………..   of sound mind freely create this will that cannot be revoked. By this will, I state that in the event that I am not physically or mentally able to make a decision regarding treatment that can prolong my life, no medical treatment should be used to delay death or prolong my life.

It is my earnest hope that my directions will be legally honored.

If I receive medical examination that establishes a condition that is incurable or irreversible, it is my wish that all medical treatment will be disregarded in any attempt to sustain my life.

I fully understand the contents of this will and sign it under no pressure whatsoever.

Signature   ………………………………………..

Address   ……………………………………….

Witness signature   ……………………………………………….

 

Download Living Will Blank Form in Word Format

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