Georgia Living Will Template
This Living Will is a legal document intended for use in the state of Georgia. It allows you to express your wishes regarding medical treatment in the event that you become unable to communicate your decisions.
Note: It is essential to discuss your preferences with your healthcare providers and loved ones to ensure everyone understands your wishes.
By signing this document, you are establishing your preferences for medical care in accordance with Georgia law.
Personal Information
Full Name: _____________________________
Date of Birth: _____________________________
Address: _____________________________
City, State, Zip Code: _____________________________
Directive Statement
If in the future I am diagnosed with a terminal condition, or if I am in a state of permanent unconsciousness, I wish to make clear the following decisions regarding my medical treatment:
- 1. I do not wish to receive the following treatments: _____________________________
- 2. I wish to receive the following treatments: _____________________________
- 3. I would like my healthcare provider to prioritize my comfort and quality of life.
Additional Instructions
In addition to my medical preferences, I would like to express the following wishes:
- 1. _____________________________
- 2. _____________________________
- 3. _____________________________
Signature
By signing this document, I affirm that I am of sound mind and voluntarily execute this Living Will.
Signature: _____________________________
Date: _____________________________
Witnessing
This Living Will must be signed in the presence of two witnesses who are not related to you or entitled to any part of your estate.
Witness 1 Signature: _____________________________
Witness 1 Name: _____________________________
Witness 2 Signature: _____________________________
Witness 2 Name: _____________________________
This document is valid according to the laws of the state of Georgia.