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Preview - New York Living Will Form
New York Living Will
This Living Will is made in accordance with New York State law to express your wishes regarding medical treatment in case you become unable to communicate your preferences.
Document Owner:
- Name: ________________________________________
- Date of Birth: ________________________________
- City: ________________________________________
- State: _______________________________________
- Zip Code: ____________________________________
Designation of Health Care Agent: If you want to appoint someone to make health care decisions on your behalf, please provide their information:
- Name of Agent: ________________________________________
- Relationship: ________________________________________
- Address: ________________________________________
- Phone Number: ________________________________________
Instructions: Specify your wishes regarding medical treatment in the following situations:
- In the event of a terminal condition:
- If I am in a persistent vegetative state:
- If I have an irreversible condition:
__________________________________________________
__________________________________________________
__________________________________________________
Please share any additional comments or instructions:
__________________________________________________
Signature: I, ____________________________ (name), confirm that I am of sound mind and have executed this Living Will as my wishes regarding health care decisions.
Date: _______________________
Create Other Common Living Will Forms for Different States
How to Write a Living Will in Florida - It communicates your values and preferences for medical care.
Advanced Directive Texas - This document is a way to protect your autonomy in medical care.
To ensure that you have a reliable plan in place for the future, it is essential to consider completing a Power of Attorney form. This vital document not only grants someone the authority to make important decisions on your behalf but also provides peace of mind knowing your preferences are honored. For guidance on how to properly fill out this form, you can visit pdftemplates.info/power-of-attorney-form/.
Michigan Living Will Form - A legal document outlining an individual's healthcare preferences in case they cannot communicate.
Advance Directives Include - A Living Will can include choices about artificial nutrition and hydration.
Similar forms
- Advance Directive: Similar to a Living Will, an advance directive provides guidance on medical treatment preferences when a person is unable to communicate. It encompasses both the Living Will and a Durable Power of Attorney for Health Care.
- Trailer Bill of Sale: The Texas Trailer Bill of Sale form is essential for documenting the transfer of ownership of a trailer, ensuring a clear and binding transaction between the seller and buyer. To securely document the sale and meet all legal requirements, you can refer to the Motor Vehicle Bill of Sale.
- Durable Power of Attorney for Health Care: This document allows individuals to designate someone to make health care decisions on their behalf. While a Living Will outlines specific wishes, a Durable Power of Attorney grants broader decision-making authority.
- Do Not Resuscitate (DNR) Order: A DNR order specifically instructs medical personnel not to perform CPR if a person's heart stops. Like a Living Will, it reflects a person's wishes regarding end-of-life care.
- Physician Orders for Life-Sustaining Treatment (POLST): This document translates a patient's wishes regarding life-sustaining treatment into actionable medical orders. It is similar to a Living Will but is often used in emergency situations.
- Health Care Proxy: A health care proxy designates a trusted individual to make medical decisions if one becomes incapacitated. This is akin to a Durable Power of Attorney but focuses specifically on health care choices.
- Do Not Intubate (DNI) Order: A DNI order indicates that a patient does not wish to be intubated or placed on a ventilator. It serves as a specific directive regarding respiratory support, similar to the broader directives found in a Living Will.