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Living Will_ Kansas

Statutory Declaration in Conformance with Kansas Natural Death Act, Kansas Statutes Section 65-28,103 DECLARATION OF ___________________ Declaration made this __________ day of ________________ 20_____. I ____________, being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under ... more>>

Living Will_ Iowa

Declaration as Provided by Iowa Code 144A.3 DECLARATION OF __________________ If I should have an incurable or irreversible condition that will cause my death within a relatively short time, it is my desire that my life not be prolonged by administration of life-sustaining procedures. If my condition is terminal and I am unable to participate ... more>>

Living Will_ Indiana

Statutory Declaration in Conformance with Indiana Living Will and Life-Prolonging Procedures Act, Indiana Code 16-8-11-12 LIVING WILL DECLARATION OF ________________ Declaration made this __________ day of _________________ 20________. I, _____________, being at least eighteen (18) years old and of sound mind, willfully and voluntarily mak ... more>>

Living Will_ Illinois

Statutory Declaration in Conformance with Illinois Natural Death Act, IL. Stat. 110 ½ Paragraph 703 DECLARATION OF ______________________ This declaration is made this __________ day of __________ 20___________. I, _____________________________, being of sound mind, willfully and voluntarily make known my desires that my moment of death shal ... more>>

Living Will_ Hawaii

Declaration as Provided by Hawaii Revised Statutes Chapter 327D, Section 4 DECLARATION A. Statement of Declarant Declaration made this __________________ day of _____________, 20_______. I, _________________ being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circ ... more>>

Living Will_ Georgia

Living Will as Provided by Georgia Code, Section 31-32-3 LIVING WILL Living will made this _________________ day of ___________. I _______________________, being of sound mind, willfully and voluntarily make known my desire that my life shall not be prolonged under the circumstances set forth below, and do declare: 1. If at any time I sho ... more>>

Living Will_ District of Columbia

Statutory Declaration in Conformance with District of Columbia Natural Death Act of 1981, D.C. Code Section 6-2422 DECLARATION OF __________________ Declaration made this __________ day of ________________ 20________. I, ________________, being of sound mind, willfully and voluntarily make known my desires that my dying shall not be artificia ... more>>

Living Will_ Connecticut

Living Testament as Provided by Connecticut Statutes Section 19a-575 TESTAMENT If the time comes when I am incapacitated to the point where I can no longer actively take part in decisions for my own life, and am unable to direct my physician as to my own medical care, I wish this statement to stand as a testament of my wishes. I ____________ ... more>>

Living Will_ Colorado

Declaration Provided by Colorado Medical Treatment Decision Act: Colorado Statutes 15-18-104 DECLARATION AS TO MEDICAL OR SURGICAL TREATMENT I _____________, being of sound mind and at least eighteen years of age, direct that my life shall not be artificially prolonged under the circumstances set forth below and hereby declare that: 1. I ... more>>

Living Will_ California

Directive to Physicians as Provided by the California Health and Safety Code: Section 7187 DIRECTIVE TO PHYSICIANS Directive made this _________________ day of ___________. I, __________________, being of sound mind, willfully and voluntarily make known my desire that my life shall not be artificially prolonged under the circumstances set ... more>>

Living Will_ Arizona

Statutory Declaration in Conformance with Arizona Medical Treatment Decision Act, AZ. REV. STAT. 36-3202 DECLARATION OF __________________ Declaration made this __________ day of ________________ 20________. I, ______________, being of sound mind, willfully and artificially prolonged under the circumstances set forth below and declare that: ... more>>

Living Will_ Alaska

Declaration as Provided by Alaska Statutes, Section 18.12.010: Life Sustaining Declaration DECLARATION of ______________ If I should have an incurable or irreversible condition that will cause my death within a relatively short time, it is my desire that my life not be prolonged by administration of life- sustaining procedures. If my con ... more>>

Living Will_ Alabama

Statutory Declaration in Conformance with Alabama Natural Death Act, Al. Code 22-8A-4. DECLARATION OF __________________ Declaration made this __________ day of ________________ 20________. I, ______________, being of sound mind, willfully and voluntarily make known my desires that my dying shall not be artificially prolonged under the cir ... more>>

Directive to Physicians_ Idaho

Directive to Physicians as Provided by Idaho Natural Death Act, Idaho Code Section 39-4504 DIRECTIVE TO PHYSICIANS Directive made this _________________ day of ___________. I _____________________, being of sound mind, willfully and voluntarily make known my desire that my life shall not be artificially prolonged under the circumstances belo ... more>>

Uniform Living Will

UNIFORM LIVING WILL OF ________________________________ To my family, my physician, my lawyer, my clergyman. To any medical facility in whose care I happen to be. To any individual who may become responsible for my health, welfare or affairs. Death is as much a reality as birth, growth, maturity and old age -- it is the one certainty of life ... more>>