California Living Will
This California Living Will is created in accordance with the California Probate Code Section 4670 et seq., which allows individuals to specify their wishes regarding medical treatment in the event they are unable to make decisions for themselves.
I, [Your Full Name], being of sound mind, voluntarily make this Declaration regarding my medical care. This document reflects my wishes and desires as follows:
1. If I become terminally ill and unable to communicate my wishes, I direct that:
- My healthcare providers should offer palliative care to keep me comfortable.
- No extraordinary measures should be taken to prolong my life.
2. If I am in a persistent vegetative state or have an incurable and irreversible condition, I request the following:
- Do not administer life-sustaining treatments.
- Allow me to pass naturally and peacefully.
3. I choose the following individual to act as my healthcare agent:
Name: _________________________________
Address: _________________________________
Phone Number: _________________________________
4. In the absence of my primary healthcare agent, I appoint the following alternate agent:
Name: _________________________________
Address: _________________________________
Phone Number: _________________________________
5. My wishes regarding organ donation are as follows:
- I wish to donate my organs and tissues after my death.
- I do not wish to donate my organs and tissues after my death.
This Living Will revokes any prior declarations made by me regarding my medical care. I wish to ensure my preferences are followed, and I understand that this document will remain in effect until I revoke it in writing.
Signed this _____ day of __________, 20___.
_______________________________ (Signature)
_______________________________ (Print Name)
Witnessed by:
_______________________________ (Witness Signature)
_______________________________ (Print Name)
_______________________________ (Date)