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Blank Living Will Form for Ohio State

A Living Will is a legal document that allows individuals in Ohio 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, ensuring that a person's choices regarding life-sustaining measures are respected. To take control of your healthcare decisions, consider filling out the Ohio Living Will form by clicking the button below.

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Table of Contents

Document Overview

Fact Name	Description
Purpose	The Ohio Living Will form allows individuals to outline their healthcare preferences in case they become unable to communicate their wishes.
Governing Law	The form is governed by Ohio Revised Code Section 2133.01 to 2133.99.
Eligibility	Any adult resident of Ohio can complete a Living Will, provided they are of sound mind.
Witness Requirement	The form must be signed in the presence of two witnesses, who cannot be related to the individual or have any financial interest in their estate.
Revocation	A Living Will can be revoked at any time by the individual, either verbally or in writing.
Healthcare Proxy	The Living Will can be used alongside a healthcare power of attorney, allowing for a designated person to make decisions on behalf of the individual.
Legal Effect	Once properly executed, the Living Will is legally binding and must be honored by healthcare providers in Ohio.

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Documents used along the form

In addition to the Ohio Living Will form, individuals may consider several other forms and documents to ensure their healthcare wishes are clearly articulated and respected. Each of these documents serves a unique purpose and can complement the Living Will in various ways.

Durable Power of Attorney for Healthcare: This document allows an individual to designate someone to make medical decisions on their behalf if they become unable to do so. It provides a trusted person with the authority to act in accordance with the individual's wishes.
Advance Directive: An advance directive is a broader term that encompasses both a Living Will and a Durable Power of Attorney for Healthcare. It outlines preferences for medical treatment and appoints a representative to make decisions if necessary.
Do Not Resuscitate (DNR) Order: A DNR order is a specific medical directive that instructs healthcare providers not to perform CPR if a person's heart stops or they stop breathing. This document is typically used in hospital settings and should be discussed with medical professionals.
Physician Orders for Life-Sustaining Treatment (POLST): A POLST form translates a patient’s wishes regarding treatment into actionable medical orders. It is designed for individuals with serious illnesses and is honored by healthcare providers across various settings.
Healthcare Proxy: Similar to the Durable Power of Attorney for Healthcare, a healthcare proxy designates a specific person to make medical decisions. This document often accompanies a Living Will to ensure that the appointed individual understands the patient’s preferences.
Organ Donation Consent Form: This form allows individuals to express their wishes regarding organ and tissue donation after death. It can be included with a Living Will to ensure that healthcare providers are aware of the individual’s intentions.
Personal Healthcare Record: This is a comprehensive document that includes medical history, medications, allergies, and other pertinent health information. It can assist healthcare providers in making informed decisions and is especially useful in emergencies.

Understanding these various documents can empower individuals to take control of their healthcare decisions and ensure that their preferences are honored. Each form plays a crucial role in the planning process and can provide peace of mind for both individuals and their loved ones.

Document Sample

Ohio Living Will Declaration

This Living Will is created in accordance with the Ohio Revised Code Section 2133, which governs the statutory requirements for advance directives in the state of Ohio. This document serves to express my wishes regarding medical treatment and end-of-life care in the event that I become unable to communicate my decisions.

Personal Information:

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

Designation of Healthcare Proxy:

If I become unable to make decisions about my medical care, I designate the following individual to be my healthcare proxy:

Proxy’s Name: _________________________________________
Relationship: _________________________________________
Phone Number: _________________________________________
Alternate Proxy’s Name: _______________________________
Relation: _________________________________________
Phone Number: _________________________________________

Medical Preferences:

In accordance with my personal values and beliefs, I wish to indicate my preferences regarding medical treatment:

I wish to receive the following medical treatments (e.g., resuscitation, mechanical ventilation, tube feeding): ________________.
If my condition is terminal, I would prefer to receive palliative care only: Yes / No.
I would like my healthcare proxy to make decisions in accordance with what they believe I would want: Yes / No.

Signature:

By signing below, I confirm that this document reflects my wishes and is made willingly, without any undue influence:

Signature: _________________________________________

Date: _________________________________________

Witnesses:

This declaration must be signed in the presence of at least two witnesses, who are not related to me and who do not stand to benefit from this document:

Witness 1: _________________________________________
Witness 2: _________________________________________

Witness 1 Signature: _________________________________________

Witness 2 Signature: _________________________________________