Health care directive (minnesota statutes 145c.16)i, , understand this document allows me to do one or both of the following:part i: name another person (called the health care agent) to make health care decisions for me if i am unable to decide...
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Declaration (living will) (755 ilcs 35/3)this declaration is made this day of (month, year). i, , being of sound mind, willfully and voluntarily make known my desires that my moment of death shall not be artificially postponed.if at any time i...
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Life prolonging procedures declaration (ic 1636411)declaration made this day of 20 (month, year). i, , being at least eighteen (18) years of age and of sound mind, willfully and voluntarily make known my desire that if at any time i have an...
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Out of hospital do not resuscitate declaration and physician 's do not resuscitate order (indiana code 1636515)this declaration and order is effective on the date of execution and remains in effect until the death of the declarant or...
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Declaration (k.s.a. 6528,103)declaration made this day of (month, year). i, being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, do hereby...
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Designation of patient advocate(mcl 700.5506 to 700.5507)explanationyou have the right to give instructions about your own health care. you also have the right to name someone else to make healthcare decisions for you. this form lets you do either...
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Declaration(revised statutes of nebraska 20404)if i should lapse into a persistent vegetative state or have an incurable and irreversible condition that, without the administration of lifesustaining treatment, will, in the opinion of my attending...
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Statutory form health care directive (north dakota century code 2306.5.17)i , understand this document allows me to do one or all of the following:part i: name another person (called the health care agent) to make health care decisions for me if i...
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Declaration concerning the use oflife sustaining treatment (ohio revised code chapter 2133) "i, , being of sound mind, desire that, as specified below, my life not be prolonged by extraordinary means or by artificial nutrition or hydration if...
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Declaration (iowa code144a.3)i, , make the following declaration:if i should have an incurable or irreversible condition that will result either in death within a relatively short period of time or a state of permanent unconsciousness from which,...
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Declaration to physicians(wisconsin living will) (wisconsin statutes 154.03)i, , being of sound mind, voluntarily state my desire that my dying not be prolonged under the circumstances specified in this document. under those circumstances, i...
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