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Blank Living Will Form for New York State

A New York Living Will is a legal document that outlines an individual's preferences regarding medical treatment in the event they become unable to communicate their wishes. This form provides clarity on end-of-life decisions, ensuring that healthcare providers and loved ones respect the individual's desires. Understanding and completing this form is essential for anyone wishing to have a say in their medical care.

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Table of Contents

Document Overview

Fact Name	Description
Purpose	A New York Living Will outlines your wishes regarding medical treatment in case you become unable to communicate your preferences.
Governing Law	The New York Living Will is governed by the New York Public Health Law, specifically Article 29-CC.
Eligibility	Any adult who is of sound mind can create a Living Will in New York.
Signature Requirements	The document must be signed by the individual or by another person at their direction and in their presence.
Witnesses	Two witnesses are required to sign the Living Will, ensuring that the person creating the document is competent and not under duress.
Revocation	You can revoke your Living Will at any time, as long as you are mentally competent to do so.
Healthcare Proxy	A Living Will can be used alongside a Healthcare Proxy, which designates someone to make medical decisions on your behalf.

Download Living Will PDF Form

Discover More Living Will Templates for Specific States

Free Health Care Proxy Form - Utilizing a Living Will can assure that your end-of-life choices are respected and maintained.

Medical Power of Attorney Pa - Consider your Living Will as a roadmap for your healthcare wishes.

Advance Directive Form Georgia - It’s wise to provide copies of your Living Will to family members and healthcare providers.

Documents used along the form

A New York Living Will is an essential document that outlines your preferences for medical treatment in case you become unable to communicate. However, several other forms and documents often accompany it to ensure your wishes are respected and your affairs are in order. Below is a list of these documents, along with brief descriptions of each.

Health Care Proxy: This document allows you to appoint someone to make medical decisions on your behalf if you are unable to do so. It ensures that your healthcare preferences are honored by a trusted individual.
Durable Power of Attorney: This grants someone the authority to manage your financial affairs, including making decisions about your assets and bills, in the event you become incapacitated.
Do Not Resuscitate (DNR) Order: This order instructs medical personnel not to perform CPR or other life-saving measures if your heart stops or you stop breathing, reflecting your wishes regarding end-of-life care.
Organ Donation Form: If you wish to donate your organs upon death, this document specifies your intentions and can help facilitate the process for medical professionals.
Advance Directive: This is a broader term that encompasses both Living Wills and Health Care Proxies, detailing your healthcare preferences and appointing someone to make decisions for you.
HIPAA Authorization: This form allows you to designate individuals who can access your medical records and discuss your health information with healthcare providers.
Will: A legal document that outlines how you want your assets distributed after your death. It can also name guardians for minor children.
Revocable Trust: This is a legal arrangement where you place your assets in a trust during your lifetime, allowing for easier management and distribution after your death.
Funeral Planning Document: This outlines your wishes regarding funeral arrangements, including burial or cremation preferences, and can relieve your family of decision-making burdens during a difficult time.
Financial Power of Attorney: Similar to a Durable Power of Attorney, this specifically focuses on financial matters, allowing someone to handle your finances if you are incapacitated.

Having these documents in place, along with your New York Living Will, can provide peace of mind. They ensure that your healthcare and financial wishes are respected, even when you cannot communicate them directly.

Document Sample

New York Living Will Template

This Living Will is made in accordance with the laws of the State of New York. It expresses your wishes regarding medical treatment in the event that you become unable to communicate your preferences.

Individual Information

Full Name: _______________________________
Date of Birth: __________________________
Address: ________________________________
City: _________________________________
State: _________________________________
Zip Code: ______________________________

In the event that I am unable to make my own medical decisions, I wish to express my preferences regarding the following:

I request that my healthcare providers take the following actions regarding life-sustaining treatment:

Provide comfort and care.
Do not initiate resuscitation.
Allow natural processes of dying.

I prefer the following treatment options:

Nutrition and hydration:

Continue as long as I can benefit.
Discontinue if I am in a terminal condition.

Respiratory support:

Use if medically indicated.
Cease if I am declared terminal.

In case of my incapacity, I designate the following individual as my healthcare agent:

Agent's Name: __________________________
Relation to Me: ______________________
Agent's Contact Number: ________________

It is my intention that this Living Will express my wishes clearly. I urge my healthcare providers and family members to respect my decisions outlined above.

Signed: _________________________

Date: __________________________