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Example - Delaware Living Will Form
Delaware Living Will Template
This Living Will is created in accordance with the laws of the State of Delaware. It serves to detail your wishes regarding medical treatment in the event you become unable to communicate your preferences.
Instructions: Please fill in the blanks and modify the template as necessary to reflect your own choices.
PART I: IDENTIFICATION
- Full Name: ________________________
- Date of Birth: ________________________
- Address: ________________________
- Phone Number: ________________________
PART II: DESIGNATION OF HEALTH CARE AGENT
I hereby appoint the following individual as my health care agent to make health care decisions on my behalf if I am unable to do so:
- Name of Health Care Agent: ________________________
- Relationship: ________________________
- Phone Number: ________________________
PART III: STATEMENT OF DESIRES, SPECIAL PROVISIONS, AND LIMITATIONS
Please express your wishes regarding specific medical treatments below. You may include any special provisions and limitations that you would like your health care agent to consider:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
PART IV: ORGAN DONATION
If you wish to donate your organs or tissues upon your death, please indicate your wishes below:
- Organ Donation: [ ] Yes [ ] No
- If Yes, please specify: ________________________
PART V: SIGNATURE AND WITNESSES
This Living Will is signed by me on this ____ day of ___________, 20__.
Signature: ________________________
In the presence of the following witnesses:
- Witness 1 Name: ________________________
- Witness 1 Signature: ________________________
- Witness 2 Name: ________________________
- Witness 2 Signature: ________________________
This document is intended to guide my health care agent and medical professionals in accordance with my wishes. It should be honored with the utmost respect.
Delaware Living Will: Usage Guide
Completing a Delaware Living Will form is an important step in expressing your healthcare preferences. After filling out the form, you will need to sign it in the presence of a witness or a notary public, depending on your choice. This ensures that your wishes are legally recognized and respected.
- Obtain the Delaware Living Will form. You can find it online or request a physical copy from a healthcare provider.
- Read the instructions carefully to understand the requirements for filling out the form.
- Begin by entering your full name and address at the top of the form.
- Specify the date on which you are completing the form.
- Clearly state your preferences regarding medical treatment in the designated section. Be specific about the types of treatments you do or do not want.
- Indicate your preferences regarding organ donation, if applicable.
- Review the completed form to ensure all information is accurate and complete.
- Sign the form in the presence of a witness or a notary public. Ensure that the witness is not a family member or someone who would benefit from your estate.
- Provide copies of the signed form to your healthcare provider and any family members involved in your care.
Documents used along the form
When preparing a Delaware Living Will, it is beneficial to consider additional documents that complement your advance healthcare planning. These forms can help ensure that your healthcare preferences are respected and provide clarity to your loved ones and medical providers. Below are several important documents often used alongside a Living Will.
- Durable Power of Attorney for Healthcare: This document allows you to designate a trusted individual to make healthcare decisions on your behalf if you become unable to do so. It empowers your agent to act in accordance with your wishes as outlined in your Living Will.
- Do Not Resuscitate (DNR) Order: A DNR order instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if your heart stops or you stop breathing. This document is particularly important in emergency situations, ensuring your wishes are known and followed.
- ATV Bill of Sale: The smarttemplates.net/ offers a comprehensive form that can streamline the sale process of an ATV, ensuring all necessary details are recorded properly.
- Healthcare Proxy: Similar to a Durable Power of Attorney, a healthcare proxy specifically allows you to appoint someone to make medical decisions for you when you are incapacitated. This person will act in your best interest, guided by your preferences.
- Advance Directive: An advance directive is a broader term that encompasses both Living Wills and Durable Powers of Attorney for Healthcare. It outlines your preferences for medical treatment and designates someone to make decisions on your behalf.
- Organ Donation Form: If you wish to donate your organs after death, this form allows you to express your intentions clearly. It can be included with your Living Will to ensure that your wishes regarding organ donation are known and respected.
- Personal Health Record: Maintaining a personal health record can be invaluable. It includes your medical history, medications, allergies, and other important health information. This document can assist healthcare providers in making informed decisions about your care.
Incorporating these documents into your healthcare planning can provide peace of mind. They ensure that your wishes are honored and that your loved ones are equipped to make informed decisions during difficult times. Always consult with a qualified professional to tailor these documents to your specific needs.
Key takeaways
Filling out a Delaware Living Will form is an important step in ensuring that your healthcare preferences are honored in the event you cannot communicate them yourself. Here are some key takeaways to consider:
- Understand the Purpose: A Living Will outlines your wishes regarding medical treatment in situations where you may be unable to express your preferences, such as terminal illness or incapacitation.
- Eligibility: You must be at least 18 years old and of sound mind to create a Living Will in Delaware.
- Clear Instructions: Be specific about the types of medical treatments you want or do not want, such as life-sustaining measures or pain relief options.
- Consultation Recommended: It’s advisable to discuss your wishes with family members and healthcare providers to ensure everyone understands your preferences.
- Signature Requirements: The Living Will must be signed by you and witnessed by two individuals who are not your relatives or beneficiaries.
- Revocation: You can revoke your Living Will at any time. Just inform your healthcare providers and destroy any copies of the document.
- Keep Copies Accessible: After completing your Living Will, provide copies to your healthcare provider, family members, and anyone else who may need to be aware of your wishes.
- Review Regularly: As your circumstances or preferences change, review and update your Living Will to ensure it reflects your current wishes.
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Form Properties
| Fact Name | Details |
|---|---|
| Definition | A Delaware Living Will is a legal document that outlines a person's wishes regarding medical treatment in the event they become unable to communicate their preferences. |
| Governing Law | The Delaware Living Will is governed by the Delaware Code, Title 16, Chapter 2502. |
| Eligibility | Any adult individual who is of sound mind can create a Living Will in Delaware. |
| Witness Requirement | The document must be signed in the presence of two witnesses who are not related to the individual or beneficiaries. |
| Revocation | A Living Will can be revoked at any time by the individual, either verbally or in writing. |
| Healthcare Proxy | While a Living Will outlines treatment preferences, it does not appoint a healthcare proxy. A separate document is needed for that purpose. |
| Effective Date | The Living Will becomes effective when the individual is diagnosed with a terminal condition or is in a persistent vegetative state. |
| Emergency Situations | In emergencies, medical personnel are required to follow the instructions outlined in the Living Will. |
| Storage and Accessibility | It is advisable to keep the Living Will in an easily accessible location and provide copies to family members and healthcare providers. |