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In the state of Florida, the Living Will form serves as a crucial document that allows individuals to express their healthcare preferences in the event they become unable to communicate their wishes. This form empowers people to make decisions about their medical treatment, particularly concerning life-sustaining procedures, in accordance with their personal values and beliefs. By completing a Living Will, individuals can specify their desires regarding resuscitation, artificial nutrition, and hydration, ensuring that their choices are respected even when they cannot voice them. It is important to note that this document only takes effect when a person is deemed terminally ill or in a persistent vegetative state. Furthermore, Florida law requires that the form be signed in the presence of two witnesses, who must not be relatives or beneficiaries of the individual’s estate, to ensure its validity. Understanding the nuances of the Living Will form can empower individuals to take control of their healthcare decisions and provide peace of mind for both themselves and their loved ones.
Form Example
Florida Living Will Template
This Florida Living Will is a legal document that reflects your healthcare preferences in the event that you are unable to communicate your wishes due to serious illness or incapacitation. This document is compliant with the Florida Statutes Chapter 765 - Florida Health Care Advance Directives. By completing this document, you can ensure that your healthcare providers and loved ones understand your desires regarding medical treatment and life-sustaining measures.
Full Legal Name: ___________________________________
Date of Birth: ___________________________________
Address: ___________________________________
City: ________________________ State: FL Zip Code: _________
Declaration
I, _________________ [Your Full Legal Name], a resident of the State of Florida, being of sound mind, hereby make this Living Will. I direct that my health care providers and others involved in my care follow my instructions as outlined in this document.
Directions for Health Care
In the event that I am unable to make my own health care decisions, I direct the following:
- I wish to receive the maximum comfort and relief from pain, including any pain-relieving medication, even if it hastens my death.
- I do not want my life to be prolonged by life-sustaining treatment, including but not limited to artificial ventilation, tube feeding, and CPR, if the situation is deemed hopeless or the burden outweighs the expected benefits.
- I wish to receive hospice care when appropriate and to die at home if possible.
- Specific limitations to these directions (if any): ___________________________________________________
Designation of Health Care Surrogate
In the event I am unable to make or communicate my health care decisions, I designate the following individual as my surrogate for health care decisions:
Name: ___________________________________
Relationship to me: ___________________________________
Primary Phone: ___________________________________
Alternate Phone: ___________________________________
If my primary surrogate is unable or unwilling to perform their duties, I designate the following individual as an alternate surrogate:
Name: ___________________________________
Relationship to me: ___________________________________
Primary Phone: ___________________________________
Alternate Phone: ___________________________________
Statement of Witnesses
I declare under penalty of perjury under the laws of the State of Florida that the individual who signed or acknowledged this living will is personally known to me, that they signed or acknowledged this living will in my presence, and that they appear to be of sound mind and under no duress, fraud, or undue influence.
Witness 1 Signature: ___________________________________ Date: ____________
Print Name: ___________________________________
Witness 2 Signature: ___________________________________ Date: ____________
Print Name: ___________________________________
This document is executed on the ____ day of _______________, 20____, at ___________________________________ [City], Florida.
Signature
Signature: ___________________________________
Date: ___________________________________
This Living Will is made voluntarily and without any coercion or undue influence. It expresses my wishes regarding my healthcare in the event I am unable to participate in medical treatment decisions.
Form Specifications
| Fact Name | Description |
|---|---|
| Purpose | The Florida Living Will form allows individuals to express their wishes regarding medical treatment in the event they become unable to communicate their preferences. |
| Governing Law | This form is governed by Florida Statutes, Chapter 765, which outlines the legal framework for advance directives in the state. |
| Eligibility | Any competent adult, aged 18 or older, can create a Living Will in Florida to ensure their healthcare decisions are honored. |
| Witness Requirements | The Florida Living Will must be signed in the presence of two witnesses who are not related to the individual and do not stand to inherit from the individual’s estate. |
Some Other Florida Forms
Florida Premarital Contract - Prenups cannot predetermine child custody or support issues, as these decisions are made based on the child’s best interests at the time of separation.
Hold Harmless Indemnity Agreement - For pet-related services, such as grooming or boarding, it protects the service provider from liability for accidents or injuries.