Georgia Living Will Template
This Living Will is made in accordance with Georgia state laws to express your wishes regarding medical treatment and end-of-life care.
Personal Information:
- Name: ________________________
- Date of Birth: ________________
- Address: ______________________
- City, State, ZIP: _____________
Declaration:
I, __________________________, being of sound mind, voluntarily make this declaration to express my wishes concerning medical treatment in the event I am unable to communicate my desires. This Living Will reflects my wishes for end-of-life care, as outlined below.
If at any time I am diagnosed with a terminal condition or an irreversible condition and unable to communicate my desires, I direct that:
- Life-sustaining treatment, including but not limited to:
- Mechanical ventilation
- Cardiopulmonary resuscitation (CPR)
- Artificial nutrition and hydration
- Shall be withheld or withdrawn, at my request.
- I prefer comfort care measures aimed at alleviating pain and ensuring my dignity.
Additional Preferences:
- Share my wishes with the following individuals:
- 1. ___________________________ (Name, Phone)
- 2. ___________________________ (Name, Phone)
Signature:
Signed this _____ day of __________, 20____.
__________________________ (Your Signature)
Witnesses:
This document must be signed in the presence of two adult witnesses who are not related to me and are not beneficiaries of my estate.
1. ___________________________ (Witness Signature, Date)
2. ___________________________ (Witness Signature, Date)
This Living Will is valid according to the laws of the State of Georgia.