California Living Will Template
This Living Will is a legal document created in accordance with California law, specifically under the California Probate Code Section 4670. It outlines your healthcare preferences in the event that you become unable to communicate your wishes.
Living Will Declaration
I, [Your Full Name], residing at [Your Address], hereby declare this document to be my Living Will. This will reflect my wishes regarding medical treatment in the event I am unable to express my desires.
1. Statement of Wishes
If I am diagnosed with a terminal condition or am in a state of permanent unconsciousness, I request the following regarding my medical care:
- I do not wish to receive life-sustaining treatment that only prolongs the dying process.
- I wish to receive comfort care to relieve pain and discomfort.
- If I have a chance of recovery, I want full measures taken to sustain my life.
2. Additional Instructions
In addition to the above, I express what I want and do not want concerning medical procedures, including:
- Resuscitation efforts (CPR): [Agree/Disagree]
- Mechanical ventilation: [Agree/Disagree]
- Artificial nutrition and hydration: [Agree/Disagree]
3. Designation of Healthcare Proxy
I designate the following individual as my healthcare agent to make medical decisions on my behalf if I am unable to do so:
Name: [Proxy's Full Name]
Address: [Proxy's Address]
Phone: [Proxy's Phone Number]
4. Witnesses
This Living Will must be signed in the presence of two witnesses who are not related to me by blood, marriage, or adoption, and who are not entitled to any part of my estate.
Witness #1: ____________________________
Witness #2: ____________________________
5. Signature
By signing below, I affirm that I am at least 18 years old and am of sound mind. This Living Will reflects my wishes and I am signing it voluntarily.
Signed: ________________________________
Date: __________________________________