Valid Living Will Form for the State of Illinois
The Illinois Living Will form serves as a crucial document for individuals wishing to express their healthcare preferences in the event that they become unable to communicate their wishes due to a medical condition. This form allows individuals to outline their desires regarding life-sustaining treatments, ensuring that their values and choices are respected during critical moments. It typically addresses various medical interventions, such as resuscitation efforts, mechanical ventilation, and nutritional support, enabling individuals to make informed decisions about their care. Importantly, the form must be signed in the presence of two witnesses or a notary public to be legally valid, emphasizing the need for proper execution. Additionally, individuals can revoke or modify their Living Will at any time, offering flexibility as personal circumstances and beliefs evolve. By taking the time to complete this document, individuals can alleviate the burden on their loved ones and healthcare providers, providing clear guidance during emotionally challenging times.
PDF Specifics
| Fact Name | Description |
|---|---|
| Governing Law | The Illinois Living Will form is governed by the Illinois Compiled Statutes, specifically 755 ILCS 35. |
| Purpose | This form allows individuals to express their wishes regarding medical treatment in case they become unable to communicate. |
| Eligibility | Any adult who is at least 18 years old can create a Living Will in Illinois. |
| Signature Requirement | The form must be signed by the individual and witnessed by two people or notarized. |
| Witness Limitations | Witnesses cannot be related to the individual or have any financial interest in the individual's estate. |
| Revocation | A Living Will can be revoked at any time by the individual, either verbally or in writing. |
| Healthcare Provider Compliance | Healthcare providers are required to comply with the wishes expressed in a valid Living Will. |
| Advance Directives | The Living Will is one type of advance directive, which helps guide medical decisions when individuals cannot speak for themselves. |
How to Write Illinois Living Will
Completing the Illinois Living Will form is an important step in expressing your healthcare preferences. The following instructions outline the necessary steps to accurately fill out the form. Ensure that you have a clear understanding of your wishes before proceeding.
- Obtain the Illinois Living Will form. You can find it online or request a physical copy from a healthcare provider.
- Begin with your personal information. Fill in your full name, address, and date of birth at the top of the form.
- Read through the sections carefully. Familiarize yourself with the options available regarding your healthcare decisions.
- Indicate your preferences. Clearly state your wishes regarding medical treatment in the appropriate sections. Be specific about the types of treatments you do or do not want.
- Sign and date the form. You must sign the document in the designated area to make it valid.
- Have the form witnessed. Illinois law requires that your Living Will be signed in the presence of two witnesses who are not related to you or beneficiaries of your estate.
- Make copies. After the form is completed and signed, make several copies to distribute to your healthcare providers and keep one for your records.
Once the form is filled out and witnessed, it is essential to communicate your wishes to your family and healthcare providers. This ensures that your preferences are understood and respected in the event of a medical emergency.
Illinois Living Will Example
Illinois Living Will Template
This Living Will is created in accordance with the laws of the State of Illinois. It expresses my wishes regarding medical treatment in the event that I become unable to communicate my preferences.
Personal Information
- Name: ________________________
- Date of Birth: __________________
- Address: ________________________
- City: ___________________________
- State: __________________________
- ZIP Code: _______________________
Health Care Preferences
If I am diagnosed with a terminal condition, or if I am in a persistent vegetative state, I make the following choices regarding my health care:
- I do not want any life-sustaining treatment if I am unable to make decisions regarding my health care.
- I do want comfort care to keep me free from pain.
- If I can no longer swallow, I do not wish to receive artificial nutrition and hydration.
- Other instructions: _____________________________________.
Health Care Agent
If I am unable to communicate my wishes about medical care, I designate the following person as my health care agent:
- Name: ________________________
- Phone Number: _________________
- Relationship: ___________________
Signature
I, ______________________________, declare that this Living Will accurately expresses my wishes regarding medical treatment. I am signing this document voluntarily, and I understand its contents.
Signature: ________________________
Date: _____________________________
Other Living Will State Forms
How to Start a Living Will - This document may also be referred to as an advance directive in some regions and legal contexts.
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