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Living Will Declaration
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Prepared by:
[Declarant Name]

Living Will Declaration

I, [Name] (hereinafter referred to as the "Declarant"), from [Address], [City], [State] in [Country], with a sound mind, memory, disposition, understanding, and of no less than eighteen (18) years of age, willfully and intentionally, on the testimony of this Living Will Declaration (hereinafter referred to as the "Contract") insist my family, physician(s), doctor(s), surgeons, medical care providers, attorney, all other slanted towards my care, or individuals who perchance is held conscientious for my health and any decisions related thereto, slightly or synchronously, to abide by the actions as set forth below pursuant to the corresponding circumstances thereby.
This Contract shall throw light upon my firm, informed, and settled commitment for refusing and refraining from using any and all life-sustaining medical care and treatment under the circumstances as indicated below.

The declarations in this Contract and the directions mentioned herein are a clear expression of my legal right to refuse the continuation of medical care and treatment for my terminal illness. I expect and trust the aforementioned people and parties to regard themselves as legally and morally bound to act in accordance with my wishes, desires, and preferences, and hence, shall be free from any legal liabilities for having undergone these directions as I mention in this Contract.
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Directions

I, hereby, direct my attending physician, doctor, surgeon, or other medical care providers to withhold or withdraw the use of any life-sustaining medical care or treatment, serving for anticipating my death, if and when I am diagnosed by some terminal physical or mental condition with an unreasonable medical expectation of recovery.
I, hereby, direct that treatment shall be limited to measures that are designed to keep me comfortable and relieved from pain, including any pain that might occur from the withdrawal of life-sustaining medical care or treatment.
I, hereby, direct that I specifically do not want the following forms of medical care and treatment if I am in the initial aforementioned condition:
  1. [List of medical care and treatment not wanted]
I, hereby, direct that in the phenomenon of the initial aforementioned condition, I do, and shall specifically need the following forms of medical care and treatment:
  1. [List of medical care and treatment needed]
I, hereby, direct that in circumstances where I am diagnosed with an additional condition prevailing the initial aforementioned condition, I shall specifically receive the following medical care and treatment:
  1. [List of medical care and treatment necessary]
This Contract shall express my ardent wishes, desires, and preferences along with the fact that I have executed my common law and constitutional rights as specified by the jurisdiction laws of the state of [State], and thus, shall not be liable for contradiction or limitation of any form.
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1. Witness Statements

With the acceptance of this Contract, I, the witness, agree and declare that the acknowledged Declarant is personally known to me and they have acknowledged this Contract in my presence with a sound mind and under no duress, fraud, illegal threat, or undue influence.

Acceptance and Signature

Thus, with a sound mind and body, intentionally and free from undue influence, the Declarant made and declared this Contract as of [Declaration Date], in the presence of the witness and notary of the state of [State], country of [Country] whose commission shall expire by [Commission Expiry Date].
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Free Living Will Declaration Templates

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