New York Living Will
This Living Will is created in accordance with the laws of the State of New York.
I, [Your Full Name], residing at [Your Address], declare that this is my Living Will. I am of sound mind and wish to make decisions about my healthcare in advance, should I become unable to do so.
In the event that I am diagnosed with a terminal illness or am unable to communicate my wishes, I direct the following:
- I do not want life-sustaining treatment if I am terminally ill, where such treatment will only prolong the process of dying.
- I wish to be kept comfortable and free from pain to the greatest extent possible, even if that may shorten my life.
- If I am in a persistent vegetative state, I do not want any means of sustaining my life.
In addition to the above, I appoint the following individual as my healthcare proxy:
Healthcare Proxy Name: [Proxy Full Name]
Proxy Address: [Proxy Address]
Proxy Phone Number: [Proxy Phone Number]
If my primary proxy is unable to serve, I appoint the following individual as my alternate proxy:
Alternate Proxy Name: [Alternate Proxy Full Name]
Alternate Proxy Address: [Alternate Proxy Address]
Alternate Proxy Phone Number: [Alternate Proxy Phone Number]
This Living Will revokes any prior Living Wills or directives I have executed. It is my intent that this document be honored and followed by all healthcare providers.
Signed this [Date] day of [Month], [Year].
Signature: [Your Signature]
Witnessed by:
- [Witness Full Name], Signature: [Witness Signature], Date: [Witness Date]
- [Witness Full Name], Signature: [Witness Signature], Date: [Witness Date]