Administrative — Living Will (Advance Directive)
Advance Medical Directive (Living Will) template. Document end-of-life care preferences, life support, and hydration/nutrition choices. Essential for patient care planning.
Template
If I am in a terminal condition or permanent unconscious state:
[ ] I WANT life-sustaining treatment (CPR, ventilator) to prolong my life.
[ ] I DO NOT WANT life-sustaining treatment. I wish to be allowed to die naturally.
[ ] I WANT artificial nutrition and hydration.
[ ] I DO NOT WANT artificial nutrition and hydration.
I direct that I be given medication to make me comfortable and relieve pain, even if it may shorten my life.
4. Additional Instructions:[Enter specific wishes here, e.g., religious preferences, organ donation]
5. Surrogate Decision Maker:If I am unable to make decisions, I designate the following person as my agent:
* Name: [Agent Name]
* Phone: [Agent Phone]
[Patient Name]
Witness 1: __________________________ Witness 2: __________________________💡 Tip: Click anywhere to edit. Changes are temporary.
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