Blank Living Will Form for Washington State Fill Out Your Document

Blank Living Will Form for Washington State

A Washington 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 ensures that healthcare providers and family members understand and respect a person's choices regarding end-of-life care. By filling out this form, you can take an important step in making your healthcare decisions known.

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Document Overview

Fact Name Description
Purpose A Washington Living Will outlines your preferences for medical treatment in case you become unable to communicate your wishes.
Governing Law The Washington Living Will is governed by the Revised Code of Washington (RCW) 70.122.
Eligibility Any adult who is at least 18 years old can create a Living Will in Washington.
Witness Requirement Two witnesses are required to sign the Living Will. They must be at least 18 years old and cannot be related to you or entitled to any part of your estate.
Healthcare Decisions This document allows you to specify your wishes regarding life-sustaining treatments, such as resuscitation and mechanical ventilation.
Revocation You can revoke your Living Will at any time. This can be done verbally or in writing.
Durability The Washington Living Will remains effective even if you become incapacitated.
Notarization Notarization is not required for the Living Will, but it can provide an extra layer of validation.
Healthcare Agent A Living Will can be combined with a Durable Power of Attorney for Healthcare, allowing you to appoint someone to make decisions on your behalf.
Distribution It is important to share copies of your Living Will with your healthcare providers and loved ones to ensure your wishes are known.

Discover More Living Will Templates for Specific States

Documents used along the form

A Washington Living Will is an essential document that outlines an individual's preferences for medical treatment in situations where they cannot communicate their wishes. However, it is often used alongside other important forms and documents that help ensure a comprehensive approach to healthcare decisions. Below is a list of other forms and documents that are frequently associated with the Washington Living Will.

  • Durable Power of Attorney for Health Care: This document allows an individual to designate a trusted person to make healthcare decisions on their behalf if they become incapacitated.
  • Advance Directive: An advance directive combines a living will and a durable power of attorney, providing a comprehensive plan for medical care preferences and appointing a decision-maker.
  • Do Not Resuscitate (DNR) Order: A DNR order instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest, reflecting the individual's wishes regarding resuscitation efforts.
  • Physician Orders for Life-Sustaining Treatment (POLST): This form translates a patient's preferences regarding life-sustaining treatments into actionable medical orders, ensuring that healthcare providers follow the patient's wishes.
  • Health Care Proxy: Similar to a durable power of attorney, a health care proxy designates someone to make medical decisions on behalf of the individual if they are unable to do so.
  • Organ Donation Consent Form: This document expresses an individual's wishes regarding organ donation after death, ensuring that their preferences are honored.
  • Medication Management Plan: A medication management plan outlines the medications a patient is taking and their purposes, which can be crucial for healthcare providers in emergencies.
  • Patient Information Form: This form collects essential information about the patient, including medical history, allergies, and emergency contacts, facilitating better care in urgent situations.
  • Emergency Medical Information Card: A small card that contains vital medical information, such as allergies and current medications, which can be carried by the individual for quick access in emergencies.

Understanding these documents and their purposes can significantly enhance an individual's ability to communicate their healthcare preferences effectively. Together, they create a robust framework for ensuring that one's wishes are respected in medical situations where they may not be able to speak for themselves.

Document Sample

Washington Living Will Template

This Living Will is designed to help you express your wishes regarding medical treatment in accordance with Washington state laws. Please fill in the blanks where indicated.

Patient Information:

  • Name: ________________________________
  • Date of Birth: ________________________
  • Address: ______________________________

Introduction:

I, the undersigned, being of sound mind and at least 18 years old, make this Living Will to express my wishes regarding medical treatment, should I become unable to communicate my decisions due to a terminal condition or a persistent vegetative state.

1. Statement of Wishes:

If I have a terminal condition or am in a persistent vegetative state, I wish to make my preferences clear regarding the following treatments:

  1. Withhold or withdraw life-sustaining treatment.
  2. Allow for palliative care to ensure comfort.
  3. Do not resuscitate (DNR) in case of cardiac arrest.

2. Additional Instructions:

Please specify any additional wishes regarding medical treatment:

__________________________________________________

3. Designated Health Care Agent:

I hereby appoint the following individual as my Health Care Agent to make medical decisions on my behalf if I am unable to do so:

  • Name: ________________________________
  • Address: ______________________________
  • Phone Number: _________________________

Date of Execution:

This Living Will is executed on this _____ day of ____________, 20____.

Signature:

__________________________ (Patient's Signature)

Witness statements:

I declare that the person signing this document is known to me and appears to be of sound mind. As witnesses, we affirm that we are not named as health care agents in this document.

  • Witness #1 Name: ________________________
  • Witness #1 Signature: ____________________
  • Witness #2 Name: ________________________
  • Witness #2 Signature: ____________________