Louisiana Living Will Template
This Living Will is created in accordance with the laws of the State of Louisiana. It outlines your wishes regarding medical treatment in the event that you become unable to communicate your preferences.
Personal Information:
- Full Name: ______________________________
- Date of Birth: _________________________
- Address: ______________________________
- City, State, Zip: ______________________
- Phone Number: ________________________
Declaration:
I, ______________________________, being of sound mind, do hereby declare this Living Will. I understand that this document expresses my wishes concerning medical treatment if I am unable to communicate my decisions.
Medical Treatment Preferences:
If I am diagnosed with a terminal condition, or if I am in a persistent vegetative state, I wish for the following:
- To receive life-sustaining treatment as long as it does not prolong the dying process.
- To receive comfort care to keep me comfortable and relieve pain.
- To refuse artificial nutrition and hydration if it only prolongs the dying process.
Additional Instructions:
Should my condition change, I wish for the following additional instructions to be followed:
- ____________________________________________________
- ____________________________________________________
- ____________________________________________________
Signature:
By signing below, I confirm that I understand the contents of this Living Will and that it reflects my wishes regarding medical treatment.
Signature: ____________________________
Date: ______________________________
Witnesses:
This document must be signed in the presence of two witnesses who are not related to me and who will not inherit from me:
- Witness 1: ____________________________
- Witness 2: ____________________________
In the event that I am unable to make my own medical decisions, I trust that my wishes will be honored as stated in this Living Will.