State Form 55316 Indiana Living Will Declaration - Indiana

State Form 55316 Indiana Living Will Declaration - Indiana

State Form 55316, Indiana Living Will Declaration - sometimes confused with an Advance Directive - is a vital piece of paperwork that allows all patients to ensure that their wishes regarding life-sustaining medical treatment are honored by doctors and healthcare professionals working in the state of Indiana. Living Will forms are legal tools used to assure that the patient's wishes with respect to the number and quality of medical procedures are carried out in their final days or when they are incapacitated.

The form was released by the Indiana State Department of Health on June 1, 2013 . A fillable State Form 55316 can be downloaded through the link below.

An Indiana Living Will is defined by Indiana Code Title 16 (Health) Chapter 4 on wills and life-prolonging procedures. The will must be voluntary, in writing, dated, and signed by the person making the declaration in the presence of at least two (2) adult witnesses. This document is not valid in Indiana if the patient is pregnant.

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What Is an Indiana Living Will?

A Living Will is a document used if a patient is for any reason unable to express their decisions and desires related to end-of-life medical care. The will comes into effect when a person is incapacitated to the point where they are no longer able to actively take part in making the decisions for their own life or unable to direct their physician to do so.

An individual has the right to print a will with the objective to give it to the medical personnel in order to inform them about the type of care they wish to have or wish to avoid in situations of terminal illnesses or incapacitation.

How to Make a Living Will in Indiana?

An Indiana Living Will template commonly includes the kinds of medical procedures administered to patients who are seriously ill. These include the following:

  • The transfusion of blood and blood products;
  • Cardiopulmonary resuscitation;
  • Diagnostic tests;
  • Dialysis;
  • The administration of drugs - specifically pain medication, food, and water;
  • Tissue and organ donation;
  • The use of a respirator;
  • Surgery.

A patient has to print out their will in several copies. It is recommended to keep the original with the other important paperwork where a family member or agent may expect to find them. The copies of the Living Will must be handed out to the medical professionals and relatives tasked with either administering the treatment or executing the will.

Download State Form 55316 Indiana Living Will Declaration - Indiana

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  • State Form 55316 Indiana Living Will Declaration - Indiana, Page 1
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