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Illinois Living Will

This Living Will is executed in accordance with the Illinois Natural Death Act and serves to express my wishes regarding medical treatment in the event that I become unable to communicate my decisions.

My Information:

  • Full Name: _________________________
  • Date of Birth: _______________________
  • Address: ____________________________
  • City: _______________________________
  • State: ______________________________
  • Zip Code: __________________________

My Wishes:

I wish to provide guidance to my healthcare providers regarding the following medical treatments:

  1. If I am in a terminal condition: I request that life-sustaining treatments be:
    • Withheld
    • Given
  2. If I am permanently unconscious: I request that life-sustaining treatments be:
    • Withheld
    • Given
  3. If I have a severe and irreversible condition: I request that life-sustaining treatments be:
    • Withheld
    • Given

My Designated Agent:

I designate the following person as my healthcare agent to make decisions on my behalf:

  • Full Name: _________________________
  • Address: ____________________________
  • Phone Number: ______________________

This Living Will reflects my wishes. It is important that my healthcare providers respect these decisions.

Signature: _______________________________

Date: ________________________

Witnesses:

  • Witness 1 Name: ________________________
  • Witness 1 Signature: ____________________
  • Witness 2 Name: ________________________
  • Witness 2 Signature: ____________________
⇓ Living Will PDF

Create Other Common Living Will Forms for Different States

Advanced Directive Texas - This form is a way to communicate your values about life and death.

Ahcd - Individuals can tailor their Living Will to reflect personal beliefs and values regarding medical care.

How to Write a Living Will in Florida - A Living Will can affirm your wishes even when you cannot speak for yourself.

For those considering their options, it's essential to familiarize yourself with the Power of Attorney form, as it plays a crucial role in your ability to delegate authority. By using this form, you can ensure that your wishes are respected, especially when faced with challenging circumstances. For more details and to access the template needed to complete this crucial legal step, visit pdftemplates.info/power-of-attorney-form.

Difference Between Trust and Will - This form fosters open conversations about healthcare preferences with loved ones.

Similar forms

A Living Will is an important document that outlines your preferences regarding medical treatment in situations where you cannot communicate your wishes. Several other documents serve similar purposes in ensuring your healthcare preferences are respected. Here are seven documents that share similarities with a Living Will:

  • Durable Power of Attorney for Healthcare: This document allows you to designate someone to make medical decisions on your behalf if you become unable to do so. Like a Living Will, it ensures your healthcare preferences are honored.
  • Advance Healthcare Directive: This is a broader term that includes both a Living Will and a Durable Power of Attorney for Healthcare. It outlines your medical treatment preferences and appoints someone to make decisions for you.
  • Do Not Resuscitate (DNR) Order: A DNR order specifically instructs medical personnel not to perform CPR if your heart stops or you stop breathing. It complements a Living Will by addressing emergency situations directly.
  • POLST (Physician Orders for Life-Sustaining Treatment): This document translates your treatment preferences into actionable medical orders. It is often used for individuals with serious health conditions and works alongside a Living Will.
  • Healthcare Proxy: Similar to a Durable Power of Attorney, a healthcare proxy allows you to appoint someone to make medical decisions for you. It is focused on ensuring your wishes are followed when you cannot express them yourself.
  • Personal Health Record (PHR): While not a legal document, a PHR contains information about your medical history and preferences. It can support your Living Will by providing context to your healthcare decisions.
  • Trailer Bill of Sale: The Motor Vehicle Bill of Sale is essential for documenting the sale of a trailer in Virginia, ensuring that both buyer and seller have a clear and legal record of the transaction.
  • End-of-Life Care Plan: This document outlines your wishes regarding end-of-life care, including pain management and comfort measures. It complements a Living Will by providing additional details about your preferences during critical times.

Each of these documents plays a vital role in ensuring that your healthcare wishes are respected and followed, especially during challenging times when you may not be able to communicate them directly.