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Fillable Living Will Template for California

A California Living Will form is a legal document that allows individuals to express their wishes regarding medical treatment in case they become unable to communicate their preferences. This important tool helps ensure that your healthcare decisions align with your values and desires. By preparing a Living Will, you can provide guidance to your loved ones and healthcare providers about your end-of-life care.

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Overview

In the heart of California's healthcare landscape lies the Living Will, a crucial document that empowers individuals to express their wishes regarding medical treatment in the event they become unable to communicate. This form plays a vital role in ensuring that personal values and preferences guide healthcare decisions, particularly in critical situations. Key aspects of the California Living Will include the ability to specify preferences for life-sustaining treatments, such as resuscitation and artificial nutrition, as well as the option to appoint a healthcare agent to make decisions on one's behalf. Additionally, the document provides clarity on what constitutes acceptable or unacceptable medical interventions, thus alleviating the burden on loved ones during emotionally charged moments. By understanding the significance and components of the California Living Will, individuals can take proactive steps to safeguard their healthcare choices and ensure their voices are heard, even when they cannot speak for themselves.

California Living Will Preview

California Living Will

This California Living Will is made to reflect the desires of the undersigned regarding healthcare decisions under the California Natural Death Act Declaration. This legal document ensures that medical treatment preferences are honored when the individual is unable to communicate their desires due to serious health conditions.

Personal Information

Full Name: ________________________________________
Date of Birth: _________________________________________
Address: _____________________________________________
City: ___________________ State: CA Zip: _______________
Phone Number: ________________________________________
Email Address: _______________________________________

Healthcare Directives

I, _________________ [Name], being of sound mind, express my wishes regarding my healthcare. In circumstances where I am unable to make my own healthcare decisions, the following should serve as a guide to my healthcare provider(s) and my family.

Life-Sustaining Treatment: In the event that my condition is determined to be terminal and I am unable to express my wishes, I do ☐ want ☐ do not want life-sustaining treatments to be provided or continued. This includes, but is not limited to, artificial ventilation, cardiopulmonary resuscitation (CPR), and artificial nutrition and hydration.
Pain Relief: Regardless of my choice regarding life-sustaining treatment, I wish to receive maximum pain relief that is consistent with comfortable and dignified end-of-life care.
Other Wishes: ________________________________________________________________ _____________________________________________________________________________.

Designation of Healthcare Agent

If I am unable to make my own healthcare decisions, I designate the following individual as my healthcare agent:

Agent's Full Name: ___________________________________________________
Relationship: ________________________________________________________
Phone Number: ________________________________________________________
Alternate Phone Number: ______________________________________________

My healthcare agent is authorized to make all health care decisions for me, including decisions about refusing or withdrawing life-sustaining treatment, under all circumstances where I myself am unable to make these decisions.

Signature

I understand the contents of this document and the consequences of any decisions made herein. This Living Will reflects my personal wishes regarding healthcare during times when I might not be able to express them myself.

Date: _______________________________
Signature: ___________________________

Declaration by Witnesses

This Living Will was signed in our presence. The principal appears to be of sound mind and free from duress at the time of signing this document.

Witness 1 Name: __________________________________________________
Witness 1 Signature: __________________________________ Date: ________
Witness 2 Name: __________________________________________________
Witness 2 Signature: __________________________________ Date: ________

⇓ Living Will PDF Form

File Characteristics

Fact Name	Description
Definition	A California Living Will is a legal document that allows individuals to outline their preferences for medical treatment in case they become unable to communicate their wishes.
Governing Law	The California Living Will is governed by the California Probate Code, specifically Sections 4600-4806.
Eligibility	Any adult who is at least 18 years old and of sound mind can create a Living Will in California.
Content Requirements	The form must clearly state the individual's wishes regarding life-sustaining treatment and should be signed by the individual and two witnesses or a notary public.
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, individuals can also designate a healthcare proxy to make decisions on their behalf if they are unable to do so.
Storage and Accessibility	It is essential to keep the Living Will in a safe place and inform family members and healthcare providers about its location.

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