Washington Living Will Template
This Living Will is made in accordance with the laws of the State of Washington. It expresses my wishes regarding medical treatment should I become unable to communicate my preferences.
Personal Information:
- Full Name: __________________________________
- Date of Birth: ________________________________
- Address: _____________________________________
- City: _________________________________________
- State: ________________________________________
- Zip Code: _____________________________________
Declaration:
In the event that I am diagnosed with a terminal condition or am in a state of permanent unconsciousness, I direct that the following medical treatments be carried out or withheld:
- Do Not Resuscitate (DNR): _____ Yes _____ No
- Life-Sustaining Treatment: _____ Yes _____ No
- Tube Feeding: _____ Yes _____ No
- Pain Relief Measures: _____ Yes _____ No
If I should require end-of-life care, I wish for my healthcare providers to follow these additional instructions:
- Comfort care measures to be prioritized.
- Family to be involved in decision-making.
- Spiritual needs to be respected and accommodated.
Signature:
I, the undersigned, affirm that I am of sound mind and voluntarily execute this Living Will. I understand its contents and effects.
Signature: ___________________________________
Date: ________________________________________