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Blank Living Will Form for California State

A California Living Will form is a legal document that allows individuals to outline their preferences for medical treatment in the event they become unable to communicate their wishes. This form provides clarity for healthcare providers and loved ones during critical times. To ensure your preferences are known, consider filling out the form by clicking the button below.

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Table of Contents

Document Overview

Fact Name	Description
Definition	A California Living Will is a legal document that allows individuals to outline their preferences for medical treatment in the event they become unable to communicate their wishes.
Governing Law	This form is governed by the California Probate Code, specifically Sections 4600-4800, which detail the requirements and implications of advance healthcare directives.
Eligibility	Any adult who is of sound mind can create a Living Will in California, ensuring their healthcare preferences are respected when they are unable to express them.
Revocation	A Living Will can be revoked at any time by the individual, as long as they are mentally competent, allowing for flexibility in changing healthcare decisions.

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Discover More Living Will Templates for Specific States

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Documents used along the form

A California Living Will is a vital document that outlines an individual's wishes regarding medical treatment in the event they become unable to communicate. However, it is often accompanied by other important forms and documents that further clarify healthcare preferences and legal matters. Below is a list of seven documents that are frequently used alongside a Living Will in California.

Durable Power of Attorney for Health Care: This document allows a person to appoint someone else to make medical decisions on their behalf if they are unable to do so. It provides flexibility and ensures that a trusted individual can advocate for the patient’s wishes.
Advance Healthcare Directive: This comprehensive document combines elements of a Living Will and a Durable Power of Attorney for Health Care. It allows individuals to specify their medical treatment preferences and designate an agent to make decisions if they cannot communicate.
Do Not Resuscitate (DNR) Order: A DNR order instructs medical personnel not to perform CPR or other life-saving measures if a person’s heart stops or they stop breathing. This document is especially important for those who wish to avoid aggressive medical interventions.
Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that outlines a patient’s preferences for treatment in emergency situations. It is designed for individuals with serious health conditions and must be signed by a physician to be valid.
Healthcare Proxy: Similar to a Durable Power of Attorney for Health Care, a healthcare proxy designates a specific individual to make medical decisions on behalf of someone else. This document ensures that a trusted person can carry out the patient’s wishes in critical situations.
Organ Donation Form: This document expresses an individual's wishes regarding organ donation after death. It can be included with a Living Will to clarify preferences and ensure that healthcare providers are aware of the individual’s intentions.
HIPAA Authorization Form: This form allows individuals to authorize specific people to access their medical records and health information. It is essential for ensuring that designated individuals can make informed decisions regarding the patient’s care.

Each of these documents plays a crucial role in ensuring that a person's healthcare preferences are respected and followed. By preparing these forms, individuals can create a comprehensive plan that addresses their medical care wishes and provides peace of mind for themselves and their loved ones.

Document Sample

California Living Will Template

This Living Will is created in accordance with the laws of the State of California. It allows you to express your healthcare preferences in situations where you may be unable to communicate your wishes.

Person's Information:

Full Name: _______________
Date of Birth: _______________
Address: _______________
City, State, Zip Code: _______________

I, the undersigned, being of sound mind, voluntarily make this declaration while I am of sound mind. This declaration reflects my wishes regarding medical treatment in the event I become unable to make decisions for myself.

Healthcare Preferences:

If at any time I am diagnosed as having a terminal illness, or I am in a persistent vegetative state or have an irreversible condition that prevents me from making my own medical decisions, I direct my medical practitioners to follow my preferences as outlined below. Please respect my wishes as follows:

1. Life-Sustaining Treatment: I wish to receive the following life-sustaining treatments: _______________
2. Pain Relief Preferences: I request the following pain relief measures be taken: _______________
3. Organ Donation: Upon my death, I wish to donate organs and tissues: _______________
4. Additional Wishes: Any other preferences regarding my health care: _______________

Appointment of Healthcare Agent:

I hereby designate the following individual as my healthcare agent to make medical decisions on my behalf should I become unable to do so:

Agent's Full Name: _______________
Agent's Phone Number: _______________
Agent's Address: _______________

This Living Will can be revoked or amended at any time. It reflects my wishes voluntarily and without any coercion.

Signature: ___________________________

Date: _______________________________

Witnesses:

It is recommended that two adult witnesses (who are not related to you) sign below:

Witness 1: ___________________________
Witness 2: ___________________________