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Blank Living Will Form for Illinois State

A Living Will is a legal document that allows individuals in Illinois to express their wishes regarding medical treatment in the event they become unable to communicate those wishes themselves. This form plays a crucial role in ensuring that a person's healthcare preferences are honored, particularly in critical situations. To ensure your wishes are respected, consider filling out the Illinois Living Will form by clicking the button below.

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Table of Contents

Document Overview

Fact Name	Details
Governing Law	The Illinois Living Will is governed by the Illinois Compiled Statutes, Chapter 755 ILCS 35.
Purpose	This form allows individuals to express their wishes regarding medical treatment in the event they become unable to communicate.
Eligibility	Any adult who is at least 18 years old can complete a Living Will in Illinois.
Witness Requirement	The form must be signed in the presence of two witnesses who are not related to the individual or entitled to any part of their estate.
Revocation	An individual can revoke their Living Will at any time, provided they do so in a manner that is clear and unequivocal.
Effectiveness	The Living Will takes effect only when the individual is diagnosed with a terminal condition or is in a persistent vegetative state.

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Documents used along the form

When preparing for future healthcare decisions, it's essential to consider several important documents alongside the Illinois Living Will form. Each of these documents serves a unique purpose in ensuring your healthcare preferences are respected. Here are four key forms that are often used in conjunction with a Living Will:

Healthcare Power of Attorney: This document allows you to designate a trusted individual to make medical decisions on your behalf if you become unable to do so. It ensures that someone you trust will advocate for your healthcare wishes.
Do Not Resuscitate (DNR) Order: A DNR order instructs medical personnel not to perform CPR if your heart stops or you stop breathing. This form is particularly important for individuals who wish to avoid aggressive life-saving measures in certain situations.
Advance Directive: An advance directive encompasses both a Living Will and a Healthcare Power of Attorney. It provides comprehensive instructions regarding your medical care preferences and appoints someone to make decisions for you if needed.
Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order that outlines your preferences for life-sustaining treatments. It is typically used for individuals with serious illnesses and must be signed by a healthcare provider to be valid.

Understanding these documents can empower you to make informed decisions about your healthcare. By having a Living Will and these additional forms in place, you can ensure that your wishes are honored, even when you may not be able to communicate them yourself.

Document Sample

Illinois Living Will Template

This Living Will is executed in accordance with the Illinois Consolidated Act, specifically under the Illinois Living Will Act (755 ILCS 35). It outlines your healthcare preferences in situations where you may not be able to communicate your wishes.

Please fill in the blanks with your personal information as needed.

Individual Information:

Full Name: ________________________________
Date of Birth: ___________________________
Address: _________________________________
City: _________________________________
State: ____________ Zip Code: ____________
Phone Number: ____________________________

Healthcare Preferences:

If I have a terminal condition or am permanently unconscious, I direct that:

I do not wish to have life-sustaining treatment administered to me.
I wish to receive pain relief and comfort care even if it may hasten my death.
I prefer my healthcare decisions to be made based on my stated preferences.

Designated Agent (Optional):

If I wish to appoint an agent to make healthcare decisions on my behalf, I appoint:

Name of Agent: ________________________________
Address: _________________________________
Phone Number: ____________________________

By signing below, I confirm that I understand this Living Will and that it reflects my medical treatment preferences. I affirm that I am of sound mind and that this document expresses my wishes regarding my healthcare.

Signature: ________________________________

Date: ________________________________

Witness 1:

Name: ________________________________

Signature: ________________________________

Date: ________________________________

Witness 2:

Name: ________________________________

Signature: ________________________________

Date: ________________________________