Florida Living Will
This Living Will is created in accordance with the Florida Statutes, Chapter 765, which govern advance directives.
I, [Your Name], of [Your Address], declare this to be my Living Will. I am of sound mind and understand the consequences of this document.
This Living Will reflects my wishes regarding the treatment I want or do not want in case I become terminally ill or permanently unconscious, and am unable to make my own decisions.
Part 1: My Wishes
In the event that I have a terminal condition or am in a persistent vegetative state, I wish to receive the following:
- All available treatments to prolong my life.
- Only comfort care, allowing a natural death.
- Specific directives regarding nutrition and hydration.
Part 2: Appointment of Health Care Surrogate
I designate the following person as my health care surrogate:
Name: [Surrogate's Name]
Address: [Surrogate's Address]
Phone Number: [Surrogate's Phone Number]
Part 3: Signature
By signing below, I confirm that I understand this document and its effects.
Signature: ___________________________
Date: ________________________________
Part 4: Witnesses
This Living Will must be witnessed by two individuals. They must not be my health care surrogate or have any vested interest in my estate.
Witness 1:
Name: [Witness 1 Name]
Signature: ___________________________
Date: ________________________________
Witness 2:
Name: [Witness 2 Name]
Signature: ___________________________
Date: ________________________________
Part 5: Notes
This Living Will should be kept where it can be easily accessed. It is advisable to share copies with your health care surrogate and family members.