California Living Will
This Living Will is prepared in accordance with the laws of the State of California.
I, [Your Full Name], residing at [Your Address], in the County of [Your County], State of California, declare that this document reflects my preferences regarding medical treatment in the event that I become unable to communicate my wishes.
1. If I become terminally ill and unable to make decisions about my medical treatment, I direct that:
- I do not want life-sustaining treatment, including but not limited to resuscitation, mechanical ventilation, or artificial nutrition and hydration.
- My healthcare providers should prioritize my comfort and quality of life.
2. If I am in a state of permanent unconsciousness, I wish for my healthcare to be directed as follows:
- Withhold any life-sustaining procedures.
- Provide palliative care to ensure my comfort.
3. In the event that I can no longer express my healthcare preferences, I appoint the following person as my healthcare agent:
[Agent's Full Name], residing at [Agent's Address], phone number: [Agent's Phone Number].
4. If my designated agent is not available or unable to serve, I appoint the following alternate:
[Alternate Agent's Full Name], residing at [Alternate Agent's Address], phone number: [Alternate Agent's Phone Number].
I understand that I have the right to revoke this Living Will at any time. This document is valid only while I am able to make decisions for myself and strictly follows California law concerning advance healthcare directives.
Signed this ____ day of __________, 20__.
Signature: _____________________________
Print Name: [Your Full Name]
Witness Signature: ______________________
Print Name: [Witness Full Name]
Witness Signature: ______________________
Print Name: [Witness Full Name]