Iowa Living Will
This Living Will is created in accordance with the laws of the state of Iowa.
I, [Your Full Name], residing at [Your Address], being of sound mind, willfully and voluntarily make this declaration for the purpose of specifying my wishes regarding medical treatment in the event of a terminal illness or condition limiting my ability to communicate my wishes.
1. If I am diagnosed with a terminal condition and unable to communicate, my wishes regarding medical treatment are as follows:
- I do not wish to receive any life-sustaining treatments, including but not limited to:
- Respiratory support
- Artificial nutrition and hydration
- Cardiopulmonary resuscitation (CPR)
2. In the situation that I am unable to make healthcare decisions, I appoint the following person as my healthcare agent:
[Agent's Full Name]
Address: [Agent's Address]
3. If my appointed agent is unable or unwilling to act, I name the following alternate agent:
[Alternate Agent's Full Name]
Address: [Alternate Agent's Address]
4. I wish for all medical personnel to follow my wishes as outlined in this document. I understand that this Living Will revokes any prior Living Wills made by me.
5. I make this declaration freely and without any coercion. I have communicated my wishes to my healthcare agent and any family members who need to be informed.
IN WITNESS WHEREOF, I have signed this Living Will on [Date].
Signature: [Your Signature]
Date: [Date]
Witness 1 Name: [Witness 1 Full Name]
Witness 1 Signature: [Witness 1 Signature]
Witness 2 Name: [Witness 2 Full Name]
Witness 2 Signature: [Witness 2 Signature]