Content Overview
Guide to Writing Pennsylvania Living Will
Filling out the Pennsylvania Living Will form is an important step in expressing your healthcare preferences. After completing the form, ensure you keep a copy for your records and share it with your healthcare provider and loved ones.
- Obtain the Pennsylvania Living Will form. You can find it online or request a copy from a healthcare provider.
- Read the instructions carefully to understand the requirements.
- Provide your full name, address, and date of birth at the top of the form.
- Indicate your preferences regarding medical treatment in the designated sections. Be clear about your wishes.
- Sign and date the form at the bottom. Your signature must be in your own handwriting.
- Have the form witnessed by two individuals who are not related to you or beneficiaries of your estate. They should also sign and date the form.
- Make copies of the completed form for your records and share it with your healthcare provider and family members.
PDF Form Specs
| Fact Name | Description |
|---|---|
| Purpose | A Pennsylvania Living Will allows individuals to express their wishes regarding medical treatment in case they become unable to communicate their decisions. |
| Governing Laws | The Pennsylvania Living Will is governed by the Pennsylvania Consolidated Statutes, Title 20, Chapter 54. |
| Requirements | The form must be signed by the individual and witnessed by two people who are not related to the individual or beneficiaries of the estate. |
| Revocation | A Living Will can be revoked at any time by the individual, either verbally or in writing, as long as they are competent to do so. |
FAQ
What is a Pennsylvania Living Will?
A Pennsylvania Living Will is a legal document that allows individuals to express their wishes regarding medical treatment in the event that they become unable to communicate those wishes themselves. This document specifically addresses end-of-life care and can guide healthcare providers and family members in making decisions that align with the individual’s preferences. By outlining your desires, you help ensure that your treatment aligns with your values, even when you cannot voice them.
Who should consider creating a Living Will in Pennsylvania?
Any adult, regardless of age or health status, should consider creating a Living Will. Life is unpredictable, and having a Living Will can provide peace of mind. It is particularly important for individuals with serious medical conditions or those who are undergoing significant medical procedures. Additionally, anyone who wishes to ensure that their healthcare preferences are respected in the event of incapacitation should take this step.
What should be included in a Pennsylvania Living Will?
A comprehensive Living Will should include several key components:
- Your medical preferences: Clearly state your wishes regarding life-sustaining treatments, resuscitation, and other medical interventions.
- Specific conditions: Indicate under what circumstances you would want certain treatments withheld or provided.
- Appointment of a healthcare proxy: Consider designating someone to make decisions on your behalf if you are unable to do so.
- Signature and date: Ensure that the document is signed and dated to confirm its validity.
Each of these elements plays a crucial role in ensuring that your healthcare preferences are honored.
How do I create a Living Will in Pennsylvania?
Creating a Living Will in Pennsylvania involves several steps:
- Obtain a form: You can find Living Will forms online or through healthcare providers.
- Complete the form: Fill out the form with your specific wishes regarding medical treatment.
- Sign the document: Sign the Living Will in the presence of two witnesses or a notary public, as required by Pennsylvania law.
- Distribute copies: Provide copies of your Living Will to your healthcare proxy, family members, and medical providers to ensure that your wishes are known.
By following these steps, you can create a legally binding document that reflects your healthcare preferences.
Can a Living Will be changed or revoked in Pennsylvania?
Yes, a Living Will can be changed or revoked at any time, as long as you are mentally competent to do so. If you wish to make changes, simply create a new Living Will that reflects your updated preferences and ensure that it is properly signed and witnessed. It is also important to inform your healthcare proxy and medical providers of any changes you make. Revoking a Living Will can be as simple as destroying the document or stating your intention to revoke it in writing.
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Pennsylvania Living Will Example
Pennsylvania Living Will
This Living Will is created pursuant to the laws of the Commonwealth of Pennsylvania. It outlines your wishes regarding medical treatment in the event you become unable to communicate those wishes.
Principal Information:
- Name: ______________________________
- Address: ___________________________
- City: ______________________________
- State: _____________________________
- Zip Code: __________________________
- Date of Birth: ______________________
Declaration:
If I become unable to make my own health care decisions, I direct that the following instructions be followed:
- I do not want my life to be prolonged by any of the following treatments if I have an incurable and irreversible condition that will result in my death within a short period of time:
- Cardiac Resuscitation
- Mechanical Ventilation
- Feeding Tubes
- Dialysis
- In the event that I am in a persistent vegetative state, I wish for the following treatment decisions to be made:
- All forms of life-sustaining treatment should be withheld.
- Pain relief measures may be administered even if they might hasten death.
Appointment of a Health Care Representative:
I hereby appoint the following individual as my health care representative:
- Name: ______________________________
- Address: ___________________________
- Phone Number: ______________________
Signature:
This declaration is made under the authority of the laws of the Commonwealth of Pennsylvania. I understand its content and implications.
Signature: ___________________________
Date: ________________________________
Witnesses:
- Witness 1 Name: ____________________
- Witness 1 Signature: ________________
- Date: ______________________________
- Witness 2 Name: ____________________
- Witness 2 Signature: ________________
- Date: ______________________________