Use our free Florida Living Will form with these simple to follow instructions. Also known as a Florida Healthcare Directive, just follow our instructions and copy, paste, print.
This form is specifically worded to follow a commonly accepted format for Florida.
When using this form for multiple states, remember that state laws vary and consulting an attorney is recommended.
After completing the living will form, consider giving a copy to an attending physician and hospital staff.
This ensures it is entered into your medical records.
Also, you should give trusted loved ones a copy of your Florida living will healthcare directive.
Anyone creating a living will should carefully consider who they choose to be their designated health care surrogate.
A health care surrogate is someone designated to make health care decisions in the event that a person can no longer competently make informed decisions.
The designated surrogate has the authority to meet with health care providers and determine the best course of action.
Other options that can be included in your Florida living will form:
The sample living will form below can be copied and pasted into your favorite word processor and edited to include any or all of these provisions.
To fill out the Florida Living Will form, just follow these instructions:
Note: Each bullet correlates to a particular blank or blanks on the sample form below.
Florida Living Will
Declaration made this ________day of_______________ , I ________________________________ willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare that, if at any time I am incapacitated and
_____ I have a terminal condition.
_____ I have an end stage condition.
_____ I am in a persistent vegetative state.
and if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.
It is my intention that this declaration be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and to accept the consequences for such refusal.
In the event that I have been determined to be unable to provide express and informed consent regarding the withholding, withdrawal, or continuation of life-prolonging procedures, I wish to designate, as my surrogate to carry out the provisions of this declaration:
I understand the full import of this declaration, and I am emotionally and mentally competent to make this declaration.
Additional Instructions (optional):_____________________________________________
---- End Sample Florida Living Will Form ----