Florida Living Will
This Living Will is created in accordance with Chapter 765 of the Florida Statutes, which governs advance directives. It serves to express your wishes regarding medical treatment in the event that you are unable to communicate those wishes yourself.
Please fill in the following information:
- Your Name: ______________________________________
- Your Address: ______________________________________
- Your City, State, Zip Code: ________________________
- Date of Birth: ____________________________________
In this document, I express my desires for medical treatment under the following conditions:
- In the event that I have a terminal condition, I do not wish to receive any life-prolonging treatments that would only postpone the moment of my death.
- If I am in a persistent vegetative state and my doctors determine I will not recover, I wish to discontinue life-sustaining procedures.
- If I am diagnosed with a condition that is incurable, I prefer comfort care only and request that any further medical interventions be withheld.
In making this Living Will, I desire to ensure that my healthcare providers and my loved ones are aware of my wishes concerning my medical treatment. I acknowledge that this document will guide my Caregivers if I am unable to participate in my own care decisions.
Signed this _____ day of _________________, 20___.
Signature: ______________________________________
Witness 1: ______________________________________
Witness 2: ______________________________________
Witnesses must be at least 18 years old and cannot be related to you by blood or marriage, nor entitled to any portion of your estate.