Arizona Living Will
This Living Will is made in accordance with Arizona state laws governing advance directives.
Personal Information
- Full Name: ___________________________
- Address: ___________________________
- City: ___________________________
- State: Arizona
- Zip Code: ___________________________
- Date of Birth: ___________________________
Declaration
I, ___________________________ (your name), being of sound mind, voluntarily make this statement as my Living Will. If I am unable to communicate my wishes regarding medical treatment, I direct my healthcare team to follow these instructions:
- Life-Sustaining Treatment: I wish to be treated with all available medical interventions to prolong my life as long as these treatments offer a reasonable hope of recovery.
- Terminal Condition: If I have a terminal condition and am unable to express my wishes, I do not wish to receive life-sustaining treatment that only prolongs the dying process.
- Permanently Unconscious: If I become permanently unconscious, I do not wish to receive treatments that would only prolong the dying process.
Additional Instructions
Any additional wishes or specific instructions can be listed here:
_______________________________________________________________
_______________________________________________________________
Signature and Witnesses
Signed this _____ day of ______________, 20__.
____________________________________
(Your Signature)
____________________________________
(Printed Name)
Witness Information
Two witnesses are required to sign this document as well. They must not be related to you by blood or marriage, nor be entitled to any part of your estate. Witnesses must sign below:
- Witness 1: ___________________________
- Witness 2: ___________________________