Florida Living Will Template
This Living Will is executed in accordance with the laws of the State of Florida, particularly under Florida Statutes Chapter 765. This document outlines the individual's wishes regarding medical treatment in the event they become unable to communicate their preferences.
Please fill in the blanks with accurate information.
I, [Full Name], residing at [Address], in the county of [County], State of Florida, declare this to be my Living Will and express my wishes regarding healthcare decisions if I become incapacitated.
1. I wish to receive the following medical treatments:
- Life-sustaining treatment
- Palliative care
- Additional treatments (please specify): [Specify]
2. In the event that I am diagnosed with a terminal condition, persistent vegetative state, or end-stage condition, I direct the following:
- Withhold or withdraw life-sustaining treatment
- Provide comfort care and pain relief
I appoint the following individual as my healthcare surrogate to make healthcare decisions on my behalf if I am unable to do so:
Name: [Surrogate's Full Name]
Address: [Surrogate's Address]
Phone: [Surrogate's Phone Number]
In witness whereof, I have signed this Living Will on the [Date] in the presence of the following witnesses:
- Witness 1: [Witness Name], Address: [Witness Address]
- Witness 2: [Witness Name], Address: [Witness Address]
Signature: [Your Signature]