[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-167759-105":53,"doc-detail-167759-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","health-care-directive-living-will-health-care-medical-power-of-attorney","HEALTH CARE DIRECTIVE (LIVING WILL) - Health Care (Medical) Power of Attorney","","Health care directive (living will) template to document an individual’s end-of-life and quality-of-life preferences when they cannot communicate. It guides decisions on withdrawing life-extending treatments when recovery is unlikely, specifies whether tube or IV food and water is desired under listed conditions, and allows refusals of specific life-sustaining treatments such as CPR, ventilation, feeding tube, and dialysis. The document also includes a medical power of attorney section naming an authorized agent, HIPAA release language, signature, witness declarations, and optional notarization instructions.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/health-care-directive-living-will-health-care-medical-power-of-attorney/167759/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/health-care-directive-living-will-health-care-medical-power-of-attorney/167759.png","ImageObject",442,249,{"name":88,"@type":89},"Miles","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-10-19","2026-08-31",true,{"@type":98,"interactionType":99,"userInteractionCount":15},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What does the living will section require you to record?","Question",{"text":108,"@type":109},"It asks you to describe your quality-of-life preferences, including when life-extending treatments should be withdrawn and whether you want food and water via tube or IV under specified conditions.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Which treatments can you refuse under the directive?",{"text":113,"@type":109},"You can check treatments you do not want under any circumstances, including CPR, ventilation (breathing machine), feeding tube, dialysis, and an optional “Other” line.",{"name":115,"@type":106,"acceptedAnswer":116},"How does the medical power of attorney work in this form?",{"text":117,"@type":109},"It names a health care agent who has full authority to make health care decisions when you are unable to make or communicate them, and it includes HIPAA release authorization plus signature, witness, and optional notary sections.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},167759,1788219079,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":15,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":9},13056703019404,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","HEALTH CARE DIRECTIVE (LIVING WILL)\nI, ___________________________, want everyone who cares for me to know what health care I want when I cannot let others know what I want.\nSECTION 1: Quality of Life Preferences\nI want my doctor to try treatments that may restore me to an acceptable quality of life. However, if my quality of life becomes unacceptable to me and my condition is irreversible, I direct that all life-extending treatments be withdrawn.\nA quality of life that is unacceptable to me includes (check all that apply):\n☐ Chronic unconsciousness (coma or persistent vegetative state)\n☐ Inability to communicate needs\n☐ Inability to recognize family or friends\n☐ Total or near total dependence on others\n☐ Other: ___________________________\nChoose one option below:\n☐ I still wish to receive food and water through a tube or IV even if I have the conditions above.\n☐ I do NOT wish to receive food and water through a tube or IV if I have the conditions above.\nSECTION 2: Refusal of Certain Treatments\nCheck the treatments you do not want under any circumstances:\n☐ Cardiopulmonary Resuscitation (CPR)\n☐ Ventilation (breathing machine)\n☐ Feeding tube\n☐ Dialysis\n☐ Other: ___________________________\nSECTION 3: End-of-Life Preferences\nWhen I am near death, it is important to me that:\n______________________________________________________________\n______________________________________________________________\n______________________________________________________________\nNOTE:\n• If you only want a Health Care (Medical) Power of Attorney, draw a large X through this page.\n• Discuss this form with your agent, your doctor(s), and loved ones.\n• Carry a copy when going to the hospital or traveling.\n• Review and update this form regularly.\n• You can revoke or modify this form at any time.\t\t\t\tJaneTemplate.com\nHEALTH CARE (MEDICAL) POWER OF ATTORNEY\nIt is important to choose someone to make healthcare decisions for you when you cannot. Inform your chosen agent about your preferences.\nI, ___________________________, as principal, designate ___________________________ as my health care agent (including mental health). My agent has full authority to make any and all health care decisions for me.\nThis power becomes effective when I am unable to make or communicate my health care decisions.\n☐ (Initial here) I authorize my agent to admit me to a psychiatric facility if required.\n☐ (Initial here) This directive cannot be revoked during incapacity.\nAgent’s Address and Phone Number:\n______________________________________________________________\nAlternate Agent: ___________________________\nAlternate Agent’s Address and Phone Number:\n______________________________________________________________\nHIPAA Release: I authorize my agent to access my health information per HIPAA guidelines.\nSIGNATURE & WITNESSING\nPrincipal’s Signature: ___________________________     Date: ________________\nWitness Declaration:\nI affirm that the individual signing this form is personally known to me, appears to be of sound mind, and acted voluntarily. I am not related by blood, marriage, or adoption, and have no claim against their estate.\nWitness Signature: ___________________________     Date: ________________\nNOTARY ACKNOWLEDGMENT (Optional)\nState of ___________________________\nCounty of ___________________________\nOn this _____ day of ________________, 20____, before me personally appeared ___________________________, known to me to be the person who executed this document.\nIn witness thereof, I hereunto set my hand and official seal.\nNotary Public: ___________________________\nMy commission expires: ___________________","cbCaidPsQ0LsbQbA","https://ap.wps.com/l/cbCaidPsQ0LsbQbA","docx",83797,"English","# SECTION 1: Quality of Life Preferences\n## Food and water preferences when conditions apply\n# SECTION 2: Refusal of Certain Treatments\n# SECTION 3: End-of-Life Preferences\n# HEALTH CARE (MEDICAL) POWER OF ATTORNEY\n## Agent authorization and effectiveness\n## HIPAA release\n# SIGNATURE & WITNESSING\n# NOTARY ACKNOWLEDGMENT (Optional)","[{\"question\":\"What does the living will section require you to record?\",\"answer\":\"It asks you to describe your quality-of-life preferences, including when life-extending treatments should be withdrawn and whether you want food and water via tube or IV under specified conditions.\"},{\"question\":\"Which treatments can you refuse under the directive?\",\"answer\":\"You can check treatments you do not want under any circumstances, including CPR, ventilation (breathing machine), feeding tube, dialysis, and an optional “Other” line.\"},{\"question\":\"How does the medical power of attorney work in this form?\",\"answer\":\"It names a health care agent who has full authority to make health care decisions when you are unable to make or communicate them, and it includes HIPAA release authorization plus signature, witness, and optional notary sections.\"}]","HEALTH CARE DIRECTIVE (LIVING WILL) - Health Care (Medical) Power of Attorney | DOCX"]