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Legal Living Will Template for California State

A California Living Will form is a legal document that allows individuals to outline their preferences regarding medical treatment in the event they become unable to communicate their wishes. This form ensures that healthcare providers and loved ones understand the person's desires regarding life-sustaining measures. By completing a Living Will, individuals can maintain control over their medical care even when they are incapacitated.

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Other Common Living Will State Templates

Physicians Directive - It allows you to state your preferences for end-of-life care.

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Can You Make a Will Yourself - A Living Will outlines your medical preferences in case you become unable to communicate them.

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Example - California Living Will Form

California Living Will

This Living Will is created in accordance with California Probate Code Section 4780 et seq. It outlines your wishes regarding medical treatment and end-of-life decisions.

Personal Information

Name: ______________________________________________________
Address: ____________________________________________________
City, State, Zip Code: ________________________________________
Date of Birth: _______________________________________________

Health Care Instructions

I, the undersigned, desire to express my wishes regarding medical treatment if I become unable to communicate my wishes. I request that the following preferences be honored:

If I am in a terminal condition or permanently unconscious, I do not wish to receive the following treatments:

Cardiopulmonary resuscitation (CPR)
Mechanical ventilation
Artificial nutrition and hydration
Other: ______________________________________

I wish to receive the following comfort care only:

Pain management
Other: ______________________________________

Appointment of Health Care Agent

If I am unable to make health care decisions, I designate the following individual as my health care agent:

Name: ______________________________________________________
Address: ____________________________________________________
Phone Number: _____________________________________________

Signature

By signing below, I confirm that I have read this document and understand its purpose. I am of sound mind and voluntarily execute this Living Will.

Signature: _________________________________ Date: ____________

Witnesses: This document must be signed in the presence of two witnesses or a notary public. Neither witness can be my health care agent or related to me by blood, marriage, or adoption.

Witness Name: ___________________________________________
Witness Signature: ________________________________________
Date: ______________________________________________
Witness Name: ___________________________________________
Witness Signature: ________________________________________
Date: ______________________________________________

Documents used along the form

A California Living Will is an important document that outlines a person's wishes regarding medical treatment in the event they become unable to communicate. However, several other forms and documents complement a Living Will, ensuring that an individual's healthcare preferences are honored. Below is a list of commonly used documents that work in conjunction with a California Living Will.

Advance Healthcare Directive: This document combines a Living Will and a Power of Attorney for Healthcare. It allows individuals to specify their medical treatment preferences and appoint someone to make decisions on their behalf if they cannot do so.
Durable Power of Attorney: This legal document allows a person to designate someone else to manage their financial and legal affairs, ensuring that decisions can be made even if they become incapacitated.
Do Not Resuscitate (DNR) Order: A DNR order instructs healthcare providers not to perform CPR if a person's heart stops or they stop breathing. It is a critical document for those who wish to avoid aggressive resuscitation efforts.
Durable Power of Attorney Template: To ensure your medical and financial decisions are respected, consider our comprehensive Durable Power of Attorney resources for your planning needs.
Physician Orders for Life-Sustaining Treatment (POLST): This form translates a patient's wishes regarding life-sustaining treatments into actionable medical orders. It is typically used for individuals with serious illnesses.
Healthcare Proxy: Similar to an Advance Healthcare Directive, a healthcare proxy allows an individual to appoint someone to make medical decisions on their behalf, ensuring their healthcare preferences are respected.
Living Trust: While primarily focused on estate planning, a living trust can include provisions for healthcare decisions, ensuring that an individual's wishes are followed in both medical and financial matters.
Will: A will outlines how a person's assets should be distributed after their death. Although not directly related to healthcare, it is essential for overall estate planning and can address final wishes regarding burial or cremation.
Organ Donation Consent: This document allows individuals to express their wishes regarding organ donation after death. It ensures that healthcare providers are aware of the person's preferences in this critical area.

These documents collectively enhance the effectiveness of a California Living Will. By preparing and organizing these forms, individuals can ensure their healthcare and personal preferences are respected during critical times.