Florida Living Will
This Living Will is executed in accordance with the laws of the State of Florida.
I, [Your Full Name], a resident of [Your County], Florida, hereby declare this to be my Living Will. I am of sound mind and at least 18 years of age. This document reflects my wishes regarding medical treatment in the event that I become unable to communicate my desires.
1. Healthcare Preferences
If I have a terminal condition, an end-stage condition, or if I am in a persistent vegetative state, I wish to make the following decisions regarding my medical care:
- Do not resuscitate me.
- Withhold or withdraw life-sustaining treatments.
- Provide comfort care and pain relief as needed.
2. Specific Instructions
In the event that my condition meets the criteria mentioned above, I specifically request the following:
- I want my family to be involved in decisions regarding my care.
- I do not wish to receive treatments that only prolong the dying process.
- Any other specific instructions: [Your Instructions]
3. Designation of Healthcare Surrogate
I hereby designate the following individual to make healthcare decisions on my behalf if I am unable to do so:
Name: [Surrogate's Full Name]
Address: [Surrogate's Address]
Phone Number: [Surrogate's Phone Number]
4. Signatures
By signing this Living Will, I affirm that I understand its contents and that it reflects my wishes:
Signature: _______________________ Date: _______________________
Witness Name: [Witness Full Name]
Witness Signature: _______________________ Date: _______________________
Witness Name: [Witness Full Name]
Witness Signature: _______________________ Date: _______________________
This Living Will should be kept in a safe place and a copy should be provided to my healthcare surrogate and doctors.