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Living Will (Rev. 1339E80)

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attending physician, or an employee of the health facility in which the declarant is

a patient.

Witness: ________________________________________ Date:

___________________

Address:

________________________________________________________________

Witness: ________________________________________ Date:

___________________

Address:

________________________________________________________________

Leadership is the art of getting someone else to do something you want done because he wants to do it. | Dwight Eisenhower