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New York Living Will
This Living Will is prepared in accordance with the laws of the State of New York. It allows you to express your wishes regarding medical treatment in case you become unable to communicate them.
Personal Information:
- Full Name: _________________________________
- Date of Birth: ____________________________
- Address: _________________________________
- City: ___________________________________
- State: ___________________________________
- Zip Code: _______________________________
Statement of Wishes:
If I am in a terminal condition or permanently unconscious, I wish to make the following wishes known regarding my medical treatment:
- I do not wish to receive life-sustaining treatment if:
- My condition is deemed terminal and there is no reasonable expectation of recovery.
- I am permanently unconscious with no hope of regaining consciousness.
- In such situations, I desire the following:
- To receive comfort care or palliative treatment that focuses on relieving pain.
- To avoid any treatment that would only prolong the dying process.
- Specific wishes regarding organ donation:
- □ I wish to donate my organs and tissues for transplantation.
- □ I do not wish to donate my organs and tissues.
- □ I wish to discuss organ donation with my family before making a final decision.
Executor of this Living Will:
- Name: _________________________________
- Address: ________________________________
- Phone Number: __________________________
Signatures:
In witness whereof, I have signed this Living Will on this _____ day of ______________, 20___.
Signature: _____________________________________
Witness 1: _____________________________________
Witness 2: _____________________________________
Each witness must affirm that the person signing this document did so in their presence.
Form Data
| Fact Name | Description |
|---|---|
| Definition | A New York Living Will is a legal document that outlines a person's wishes regarding medical treatment in the event they become unable to communicate their preferences. |
| Governing Law | The New York Living Will is governed by the New York Public Health Law, specifically Article 29-CC. |
| Requirements | To be valid, the Living Will must be signed by the individual and witnessed by at least one other person who is not a relative or a beneficiary. |
| Types of Decisions | The document can specify preferences about life-sustaining treatments, resuscitation, and other medical interventions. |
| Durability | A Living Will remains effective until it is revoked or until the individual passes away. |
| Healthcare Proxy | While a Living Will outlines treatment preferences, individuals can also appoint a healthcare proxy to make decisions on their behalf. |
| Accessibility | It is advisable to keep copies of the Living Will in accessible locations and to share them with healthcare providers and family members. |
New York Living Will - Usage Guidelines
Filling out the New York Living Will form is an important step in planning for your healthcare preferences. This document allows you to express your wishes regarding medical treatment in case you become unable to communicate them yourself. The following steps will guide you through the process of completing the form.
- Obtain the New York Living Will form. You can find it online or request a copy from a healthcare provider.
- Read the instructions carefully. Make sure you understand the terms and options available on the form.
- Fill in your personal information. This includes your full name, address, and date of birth.
- Specify your preferences regarding medical treatment. Indicate what types of life-sustaining treatments you would want or not want.
- Consider appointing a healthcare proxy. This person will make decisions on your behalf if you are unable to do so.
- Sign and date the form. Ensure that you do this in the presence of at least one witness.
- Have your witness sign the form as well. They should also provide their contact information.
- Make copies of the completed form. Keep one for your records and provide copies to your healthcare proxy and medical providers.
Once you have completed the form, it is essential to discuss your wishes with your healthcare provider and loved ones. This ensures that everyone understands your preferences and can act accordingly if the need arises.
Some Other Living Will State Templates
Living Will Free Forms - It is important to discuss your preferences with your family and healthcare providers before finalizing your Living Will.
A Colorado Do Not Resuscitate (DNR) Order form is a legal document that allows individuals to refuse resuscitation efforts in the event of a medical emergency. This form ensures that a person's wishes regarding life-sustaining treatment are respected by healthcare providers. For those seeking to learn more about this process, resources such as Colorado PDF Templates can provide valuable guidance. Understanding how to properly complete and utilize this form is essential for anyone considering their end-of-life care options.
Living Will Form Texas - You may wish to review your Living Will regularly to ensure it still reflects your wishes.
Dos and Don'ts
When filling out the New York Living Will form, it's crucial to approach the task with care and consideration. Here’s a list of things you should and shouldn’t do to ensure your wishes are accurately documented and respected.
- Do clearly state your medical preferences.
- Do discuss your wishes with family members and loved ones.
- Do sign and date the form in the presence of a witness.
- Do keep a copy of the completed form for your records.
- Do review and update your Living Will as needed.
- Don't use vague language that could lead to confusion.
- Don't forget to check state-specific requirements.
- Don't sign the form without understanding its contents.
- Don't assume that verbal wishes will be honored without documentation.
By following these guidelines, you can create a Living Will that reflects your wishes and provides clarity for your loved ones during difficult times.
Common mistakes
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Not Understanding the Purpose: Many individuals fill out the New York Living Will form without fully grasping its purpose. A Living Will is intended to outline your preferences regarding medical treatment in situations where you cannot communicate your wishes. Without this understanding, people may provide vague or incomplete instructions.
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Failure to Specify Preferences: Some people neglect to clearly specify their preferences for medical treatment. For instance, they might state a general desire for life-sustaining treatment without detailing specific conditions under which they would want such treatments withheld. This ambiguity can lead to confusion for healthcare providers and loved ones.
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Not Discussing with Family: A common mistake is failing to discuss the contents of the Living Will with family members. Open conversations about your wishes can help ensure that your loved ones understand your decisions and can advocate for you if necessary. Without these discussions, they may struggle to honor your intentions.
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Inadequate Witnessing: The New York Living Will form requires proper witnessing to be valid. Individuals often overlook this requirement or mistakenly assume that a family member can serve as a witness. In reality, witnesses must be disinterested parties who are not beneficiaries of your estate.
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Not Updating the Document: Life circumstances change, and so do personal beliefs and preferences. Failing to update the Living Will can result in outdated directives that no longer reflect your current wishes. Regularly reviewing and revising the document is essential for ensuring it remains relevant.
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Neglecting to Inform Healthcare Providers: After completing the Living Will, some individuals forget to share it with their healthcare providers. It is crucial to provide copies of the document to your doctors and ensure they understand your wishes. This step helps ensure that your preferences are respected during medical emergencies.