Illinois Living Will
This Living Will is created in accordance with the Illinois Living Will Act.
I, [Your Name], residing at [Your Address], born on [Your Date of Birth], hereby declare this as my Living Will.
If at any time I am unable to make my own healthcare decisions due to a terminal condition or permanent unconsciousness, I wish to provide guidance to my healthcare providers and loved ones regarding my treatment preferences.
My instructions regarding medical treatment are as follows:
- I wish to receive all available medical treatments that have a reasonable chance of prolonging my life.
- If I am diagnosed with a terminal illness, I do not wish to receive treatments that only serve to prolong the dying process.
- If I am in a state of permanent unconsciousness, I do not wish to be kept alive by artificial means.
- I prefer to receive palliative care to keep me comfortable.
Furthermore, I designate the following person(s) to make medical decisions on my behalf if I am unable to do so:
- Name: [Designee 1 Name], Phone: [Designee 1 Phone]
- Name: [Designee 2 Name], Phone: [Designee 2 Phone]
I acknowledge that this Living Will reflects my wishes regarding my medical treatment. I understand that I may revoke this document at any time.
Signed this [Date] day of [Month], [Year].
[Your Signature]