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Download "Living Will" - Delaware

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Delaware Living Will
I, _______________________________ with a mailing address of ______________
____________________________________________________________________,
being of sound mind, memory, disposition, understanding, and at least eighteen years
of age, do willfully and freely, by this Living Will, direct my family, physician(s),
attorney, and any other individuals who may in the future become responsible for my
health and well-being and any resolutions related thereto, whether partly or fully, to
take the following actions in each of the circumstances described in this Living Will
below.
1. If I develop a condition deemed to be “terminal” with my attending physician
and one other medical professional both agreeing within a reasonable degree of
medical certainty that I cannot be cured, I request the following:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
2. If I fall into a coma with my attending physician and one other medical
professional both agreeing within a reasonable degree of medical certainty that
there is no chance for recovery, I direct the following:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
3. If I develop a persistent vegetative state with my attending physician and one
other medical professional both determining within a reasonable degree of
medical certainty that there is no chance for recovery, I request the following:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Delaware Living Will
I, _______________________________ with a mailing address of ______________
____________________________________________________________________,
being of sound mind, memory, disposition, understanding, and at least eighteen years
of age, do willfully and freely, by this Living Will, direct my family, physician(s),
attorney, and any other individuals who may in the future become responsible for my
health and well-being and any resolutions related thereto, whether partly or fully, to
take the following actions in each of the circumstances described in this Living Will
below.
1. If I develop a condition deemed to be “terminal” with my attending physician
and one other medical professional both agreeing within a reasonable degree of
medical certainty that I cannot be cured, I request the following:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
2. If I fall into a coma with my attending physician and one other medical
professional both agreeing within a reasonable degree of medical certainty that
there is no chance for recovery, I direct the following:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
3. If I develop a persistent vegetative state with my attending physician and one
other medical professional both determining within a reasonable degree of
medical certainty that there is no chance for recovery, I request the following:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
4. In addition to the directions I have listed on this Living Will, I also want the
following:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Signatures
Principal
By signing this Living Will in front of the witnesses named below, I hereby execute
and subscribe to the statements made in this Living Will both freely and voluntarily,
and wholeheartedly request that my family, physician(s), attorney, and any other
individuals who may in the future become responsible for my health and well-being
and any decisions related thereto, whether partly or fully, all abide by my wishes as
pronounced herein.
_________________________________
Name
_________________________________
Signature
_________________________________
Date of signing
Witnesses
This Living Will was signed by _________________________________ in the
presence of the following two witnesses, who by their signatures below, confirm that
_________________________________ was, at the time this document was signed,
at least eighteen years of age, of sound mind, memory, disposition, understanding, not
under any improper influence and able to understand the weight of this decision. The
undersigned have subscribed this document in the presence of each other and
_________________________________ and at their request.
First Witness: ​ _ ________________________________ ​ w ith a mailing address of
____________________________________________________________________.
_________________________________
Signature
_________________________________
Date of signing
Second Witness: ​ _ ________________________________ ​ w ith a mailing address of
____________________________________________________________________.
_________________________________
Signature
_________________________________
Date of signing
Notary Acknowledgement
STATE OF DELAWARE
COUNTY OF _________________________________
I, _________________________________, a Notary Public of said County, do certify
that _________________________________, as Principal, and __________________
________________ and _________________________________, as witnesses,
whose names are signed to the writing above bearing date on the _______ day of
______________, ______, have this day acknowledged the same before me.
Given under my hand this _______ day of ______________, ______.
My commission expires: ___________________________________
______________________________________
Signature of Notary Public
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What Is a Delaware Living Will?

A Living Will is a legal form that lets all participating parties know about the kind of medical care and palliative care a patient wishes to receive. When creating a will, the individual will be deciding on the types of care that they are willing to receive and the types of medical care they will not be receiving. For example, some people choose to not be resuscitated if they stop breathing while in a coma, while others choose to remain on life support.

An individual can print out a basic Living Will template with or without the assistance of an attorney. The document may be revoked in writing or orally, by either the patient (the person making the will) or by a designated proxy (the person elected to make healthcare-related decisions for the patient).

How to Make a Living Will in Delaware?

A basic Living Will template can be completed without a lawyer or an attorney. In order to create a will in Delaware, an individual must be competent, be wanting to complete all paperwork voluntarily and sign the document.

A legal will can be either very broad or very specific in nature according to the wishes of the patient. It is basically the patient's declaration - a written statement of what they want to occur in the event of a serious accident or illness. It is primarily directed to the medical personnel and focuses on the type of care the patient wishes to have or not to have, under situations of terminal illness or incapacitation.