Living Will – Declaration as to Life Sustaining Procedures

This Living Will allows an adult (the declarant) who has the decisional capacity to set forth his or her written decisions as to the acceptance or rejection of medical or surgical treatment in the event the declarant has a terminal condition or is in a persistent vegetative state. This form may not be appropriate if you have executed other declarations with respect to future medical treatment, including medical durable powers of attorney. The One-Stop Legal Shop Medical Power of Attorney, however, is designed to be used with this form. This form should be completed with your appropriate medical provider.

  • Financial/General POA Declarant Information

  • Person granting authority
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