[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-167758-105":53,"doc-detail-167758-en":127},{"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":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","living-will-health-care-directive-form-template","LIVING WILL - HEALTH CARE DIRECTIVE - Form template","","Living Will (Health Care Directive) template enables the Principal to document wishes for medical care when unable to communicate. It addresses decisions about life support, including withdrawing life-prolonging treatments if quality of life is defined as unacceptable and irreversible. It also allows selection or refusal of specific life-sustaining treatments such as CPR, ventilation, feeding tubes, and dialysis. The form includes sections for end-of-life wishes and requires signatures from the Principal, witness acknowledgments, and notary acknowledgment.",{"@graph":63,"@context":119},[64,80,102],{"@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/living-will-health-care-directive-form-template/167758/",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/living-will-health-care-directive-form-template/167758.png","ImageObject",442,249,{"name":88,"@type":89},"Levi","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-10-20","2026-08-31",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",10,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"When does the Living Will take effect?","Question",{"text":109,"@type":110},"It applies when the Principal is unable to communicate their wishes and is facing circumstances where doctors determine the condition will not improve and the quality of life is unacceptable as defined in the form.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What life support decisions can the Principal make?",{"text":114,"@type":110},"The Principal can direct a concerted effort to return to an acceptable quality of life, but if quality becomes unacceptable and irreversible, they can direct withdrawal of treatments that extend life. They can also choose whether to continue food and water by tube or intravenously (IV).",{"name":116,"@type":107,"acceptedAnswer":117},"Which treatments can be refused under this directive?",{"text":118,"@type":110},"The form allows refusal of treatments administered under any circumstance, including CPR, ventilation (breathing machine), feeding tube, dialysis, and an optional “other undesired treatments” entry.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},167758,1788219063,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":126,"read_time":9},7971461740909,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","LIVING WILL (HEALTH CARE DIRECTIVE)\nThis form was completed and signed on \u0013 FORMTEXT \u0014[MM/DD/YYYY]\u0015.\nI, \u0013 FORMTEXT \u0014[PRINCIPAL NAME]\u0015, with a street address of \u0013 FORMTEXT \u0014[PRINCIPAL STREET]\u0015, City of\n\u0013 FORMTEXT \u0014[PRINCIPAL CITY]\u0015, County of \u0013 FORMTEXT \u0014[PRINCIPAL COUNTY]\u0015, State of \u0013 FORMTEXT \u0014[PRINCIPAL STATE]\u0015, with the last four (4) digits of my social security number (SSN) being XXXX - XX - \u0013 FORMTEXT \u0014[XXXX]\u0015 (hereinafter referred to as the ‘Principal’) desire to advise my doctors and medical providers of my wishes for my health care in the event I am not able to communicate my wishes.\nLIFE SUPPORT\nI desire that my doctor make a concerted effort to return me to an acceptable quality of life using then available treatments and therapies. However, if my quality of life becomes unacceptable as I have defined below and my doctors have determined that my condition will not improve (is irreversible), I direct that all treatments that extend my life be withdrawn.\nAn unacceptable quality of life means (initial and check all that apply):\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - Chronic coma or persistent vegetative state\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - no longer able to communicate my needs\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - no longer able to recognize family or friends\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - total dependence on others for daily care\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - Other: \u0013 FORMTEXT \u0014[OPTIONAL - OTHER UNACCEPTABLE QUALITY OF LIFE]\u0015.\nInitial and check only one:\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - Even if I have the quality of life described above, I still wish to be treated with food and water by tube or intravenously (IV).\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - If I have the quality of life described above, I do NOT wish to be treated with food and water by tube or intravenously (IV).\nCERTAIN LIFE-SUSTAINING TREATMENT\n(Some people do not wish to have certain life sustaining treatments under any circumstance, even if recovery is a possibility. You do not have to initial and check any of the options below if you do not wish to.)\nI do not wish to have the following treatments administered under any circumstances:\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - Cardiopulmonary Resuscitation (CPR)\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - Ventilation (breathing machine)\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - Feeding tube\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - Dialysis\n\u0013 FORMTEXT \u0014[INITIALS]\u0015 \u0003☐\u0004 - Other: \u0013 FORMTEXT \u0014[OTHER UNDESIRED TREATMENTS]\u0015\nEND OF LIFE WISHES\nWhen I am near death, it is important to me that:\n\u0013 FORMTEXT \u0014[WRITE END OF LIFE WISHES HERE]\u0015\nI have signed this document on \u0013 FORMTEXT \u0014[MM/DD/YYYY]\u0015.\n\u0013 HYPERLINK \"https://esign.com/\" \u0014___________________________________\u0015\t\t\u0013 FORMTEXT \u0014[PRINCIPAL PRINTED NAME]\u0015\nPrincipal’s Signature\t\t\t\tPrinted Name\nWITNESS ACKNOWLEDGMENT\nOn the date set forth above, I hereby state as follows:\nThe above named person is personally known to me, and I believe him/her to be of sound mind and to have voluntarily executed this document. I am at least 18 years old and not related to him/her by blood, marriage or adoption. To my knowledge, I am not a beneficiary of his/her will or any codicil, and I have no claim against his/her estate. I am not directly involved in his/her health care.\n\u0013 HYPERLINK \"https://esign.com/\" \u0014___________________________________\u0015\t\t\u0013 FORMTEXT \u0014[WITNESS PRINTED NAME]\u0015\nWitness Signature\t\t\t\t\tPrint Name\n\u0013 FORMTEXT \u0014[WITNESS ADDRESS]\u0015\t\t\t\t\u0013 FORMTEXT \u0014[WITNESS PHONE NUMBER]\u0015\nAddress\t\t\t\t\t\tPhone Number\n\u0013 HYPERLINK \"https://esign.com/\" \u0014___________________________________\u0015\t\t\u0013 FORMTEXT \u0014[WITNESS PRINTED NAME]\u0015\nWitness Signature\t\t\t\t\tPrint Name\n\u0013 FORMTEXT \u0014[WITNESS ADDRESS]\u0015\t\t\t\t\u0013 FORMTEXT \u0014[WITNESS PHONE NUMBER]\u0015\nAddress\t\t\t\t\t\tPhone Number\nNOTARY ACKNOWLEDGMENT\nState of \u0013 FORMTEXT \u0014[NOTARY ONLY: STATE]\u0015}\nCounty of \u0013 FORMTEXT \u0014[NOTARY ONLY: COUNTY]\u0015}\nI, the undersigned authority in and for said County in said State, hereby certify that the Principal \u0013 FORMTEXT \u0014[NOTARY ONLY: PRINCIPAL NAME]\u0015, whose name is signed above in this living will, and who is known to me,","cbCaigWqp8SDqTjE","https://ap.wps.com/l/cbCaigWqp8SDqTjE","docx",39012,"English","# Life support\n## Life support decisions\n## Certain life-sustaining treatment refusals\n# End of life wishes\n# Signatures and acknowledgments\n## Witness acknowledgment\n## Notary acknowledgment","[{\"question\":\"When does the Living Will take effect?\",\"answer\":\"It applies when the Principal is unable to communicate their wishes and is facing circumstances where doctors determine the condition will not improve and the quality of life is unacceptable as defined in the form.\"},{\"question\":\"What life support decisions can the Principal make?\",\"answer\":\"The Principal can direct a concerted effort to return to an acceptable quality of life, but if quality becomes unacceptable and irreversible, they can direct withdrawal of treatments that extend life. They can also choose whether to continue food and water by tube or intravenously (IV).\"},{\"question\":\"Which treatments can be refused under this directive?\",\"answer\":\"The form allows refusal of treatments administered under any circumstance, including CPR, ventilation (breathing machine), feeding tube, dialysis, and an optional “other undesired treatments” entry.\"}]","LIVING WILL - HEALTH CARE DIRECTIVE - Form template | DOCX"]