Living Will Sample


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Wettelijk Privé Notaris gezondheidszorg vrije levenswil Gezondheid medisch geneeskunde wil Medische specialiteiten Clinisch medicijn Gezondheidswetenschappen leven Aangever Medische geesteswetenschappen testament en testament

How to write a Living Will Sample? Download this Living Will Sample template that will perfectly suit your needs.

We provide the Last Will Form in a document file, that covers a myriad of contingencies, and is a framework in which you could add and modify your own provisions. A simple Last Will Testament will identify the following basic elements: 

  • Assets: either real assets (tangible personal property, land, or home), 
    • Digital assets (online accounts, cryptocurrency, social networking, or domain names), 
    • Money in various accounts that should be distributed according to your wishes.
    • Designated Beneficiaries: your spouse, children, relatives, and friends who you want to receive your property 
  • Executor: who will be granted the power and authority to wind up your affairs and carry out your wishes stated in the Will, as well as the extent of their discretion 
  • Guardian: who will take care of your children under the age of 18 years if you and your spouse pass away unexpectedly
  • Pet Caretaker: if you have certain animals who will need to be taken care of after you pass, you should name responsible caretakers and can even designate certain funds to be used so that it does not become a financially burden on your friend 
  • Probate Bonds: if you pass away without a Will, the court will appoint an Executor or Administrator to oversee the distribution of your property but a probate bond is often required to protect the heirs from any possible mismanagement or fraud -- appointing an Executor of your choosing is often coupled with a statement that you will not require them to post a probate bond 
  • Residuary Estate: anything left in your estate after all debts have been paid should then be distributed according to your preferred priority Signatures: you and your witnesses must sign but check your state laws about who can serve as a witness.
Living Will Sample:

  • I, Person, being of sound mind, willfully and voluntarily make known my desires that my dying shall not be artificially prolonged under the circumstances set forth below, do declare:
  • If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two (2) physicians who have personally examined me, one of whom shall be my attending physician, and the physicians have determined that my death will occur whether or not life-sustaining procedures are utilized and where the application of life-sustaining procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld or withdrawn and that I will be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.
  • In the absence of my ability to give directions regarding the use of such life-sustaining procedures, it is my intention that this declaration shall be honored by my family and physician(s) as the final expression of my legal right to refuse medical or surgical treatment and I accept the consequences from such refusal.
  • I understand the full import of this declaration and I am emotionally and mentally competent to make this declaration...
  • This Will Declaration made that I, being of sound mind, willfully and voluntarily make known my desires that my dying shall not be artificially prolonged under the circumstances set forth below, do declare: If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two (2) physicians who have personally examined me, one of whom shall be my attending physician, and the physicians have determined that my death will occur whether or not life-sustaining procedures are utilized and where the application of life-sustaining procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld or withdrawn and that I will be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

Our collection of online health templates aims to make life easier for you. Our site is updated every day with new health and healthcare templates. By providing you this health Living Will Sample template, we hope you can save precious time, cost, and effort and it will help you to ensure you have arrange your Last Will properly. This blank health Living Will Sample is intuitive, ready-to-use, and structured in a smart way. Try it now and let this template inspire you. We certainly encourage you to use this Living Will Sample. for your own good.

Download this simple Living Will Sample now!


For example: health care directive, mental health treatment plan, health management report, allergy log, healthy weekly meal plans, sick leave letter, health evaluation form, and much more.  All business templates are easy and quick to find, crafted by professionals, easy-to-customize, wisely structured, ready-made, and intuitive. Pay close attention to the several options available for you by browsing through the list of health-related templates. Take the time to review and choose the variety of healthcare templates to suit your need.


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Hoewel all content met de grootste zorg is gecreërd, kan niets op deze pagina direct worden aangenomen als juridisch advies, noch is er een advocaat-client relatie van toepassing.


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