Homepage Legal Living Will Form Blank Living Will Form for California
Content Overview

In California, the freedom to make decisions about one’s own health care, especially at life's end, is held in high regard. The California Living Will form, a vital part of this process, empowers individuals to express their wishes regarding medical treatment in circumstances where they might not be able to communicate their preferences directly. This document, also known as an advance health care directive, serves as a beacon, guiding family members and healthcare providers towards the decisions the declarant would have made themselves. Covering a wide range of treatments and interventions, from life-sustaining measures to pain relief preferences, the form comprehensively addresses the spectrum of potential medical decisions. Its major aspects include the appointment of a health care agent, the specificity of instructions for care, and legal considerations that ensure the document's enforceability. Moreover, it highlights the declarant's values and personal wishes, which can significantly ease the decision-making burden on loved ones during challenging times. Integral to estate planning, this document aligns with the state's legal framework, ensuring that residents can assert control over their future health care in a dignified and self-directed manner.

Example - California Living Will Form

This California Living Will document is prepared in accordance with the California Natural Death Act. It is designed to express the wishes of the individual regarding their medical treatment in the event they are unable to communicate their decisions due to incapacity.

Personal Information

  • Full Name: ____________
  • Date of Birth: ____________
  • Address: ____________
  • City: ____________
  • State: California
  • Zip Code: ____________
  • Phone Number: ____________
  • Email Address: ____________

Designation of Health Care Agent

I, ____________ (name), appoint the following person as my agent to make health care decisions for me:

  • Agent's Full Name: ____________
  • Relationship to me: ____________
  • Agent's Address: ____________
  • Agent's Phone Number: ____________
  • Alternative Agent's Full Name: ____________
  • Relationship to me (Alternative Agent): ____________
  • Alternative Agent's Address: ____________
  • Alternative Agent's Phone Number: ____________

Instructions for Health Care

In the event that I am unable to make my own health care decisions, I direct that my health care providers and my agent follow my instructions as indicated below:

  1. I do/do not (circle one) want my life to be prolonged by life-sustaining treatments if I am in a terminal condition or in a permanent unconscious state. Specific instructions: ____________
  2. I do/do not (circle one) want to receive nutrition and hydration provided by medical means if I am unable to take food or water by mouth. Specific instructions: ____________
  3. Other instructions, including preferences about pain relief, hospital care, palliative care, and any other specific treatments I want or do not want: ____________

Signature and Witnesses

This Living Will is effective as of the date signed. My signature affirms that I am of sound mind, understand the contents of this document, and have made these decisions of my own free will.

Principal's Signature: ____________ Date: ____________

Witnesses (Must be 18 years of age or older and not related to the principal by blood, marriage, or adoption, and not entitled to any portion of the principal's estate.)

  • Witness 1 Signature: ____________ Date: ____________
  • Witness 1 Printed Name: ____________
  • Witness 2 Signature: ____________ Date: ____________
  • Witness 2 Printed Name: ____________

PDF Form Attributes

Name of Fact Description
Legal Name California Advance Health Care Directive
Governing Law California Probate Code, Division 4.7 - Health Care Decisions, Sections 4600-4806
Components Power of Attorney for Health Care and Individual Instructions (Living Will)
Purpose To outline an individual's health care preferences and appoint an agent to make decisions on their behalf if they are unable to do so
Agent's Role Make health care decisions in accordance with the individual's documented wishes, or as they believe the individual would want, when the individual is unable to make decisions themselves
Required Signatures The form must be signed by the individual creating the directive and either two witnesses or a notary public
Witness Requirements Witnesses must be adults; one must not be related to the individual by blood, marriage, or adoption, and not entitled to any portion of the individual's estate
Revocation Method The directive can be revoked at any time by the individual, regardless of their mental state, through a written declaration, by orally informing the supervising health care provider, or by creating a new directive
Accessibility It is recommended that individuals inform their family, close friends, and health care providers of the directive and consider registering it with the California Secretary of State's Advance Health Care Directive Registry

Instructions on How to Fill Out California Living Will

Filling out a California Living Will is a proactive step for individuals who wish to make their healthcare preferences known in anticipation of a situation where they may not be able to communicate their wishes directly. This document allows you to specify the types of medical treatment you do or do not wish to receive if you become incapacitated. It is a straightforward process that requires attention to detail to ensure your wishes are clearly understood.

  1. Begin by identifying yourself: Write your full legal name, date of birth, and address at the top of the form to clearly establish your identity.
  2. Choose your healthcare agent carefully: If the form permits, nominate a trusted person as your healthcare agent—someone who will make medical decisions on your behalf if you're unable to do so. Include their full name, relationship to you, and contact information.
  3. Make your treatment preferences known: Clearly state which life-sustaining treatments you consent to and which you refuse. This may include decisions about mechanical ventilation, artificial nutrition and hydration, resuscitation efforts, and palliative care.
  4. Consider your end-of-life wishes: Specify your preferences regarding end-of-life care, such as hospice care, at-home care, or hospital care. Also, address your views on pain management and comfort measures.
  5. Organ donation preferences: If you wish to donate your organs, make sure to include this in your living will. Clearly indicate which organs you wish to donate and for what purposes - transplantation, educational, or scientific research.
  6. Signatures are crucial: Your living will must be signed to be valid. Sign and date the form in the presence of two witnesses or a notary public, depending on state requirements. Witnesses should not be people who stand to benefit from your death or healthcare providers currently treating you. Their signatures will also be required.
  7. Make copies and distribute them: After your living will is completed and signed, make several copies. Provide one to your healthcare agent, one to your primary care physician, and keep one for your personal records. Consider giving copies to close family members as well.

After filling out the California Living Will form, it is important to review it occasionally, especially after any significant life events such as marriage, the birth of a child, divorce, or a major change in health status. Updating your living will ensures that it always reflects your current wishes and circumstances. Remember, clear communication with your healthcare agent, family, and healthcare providers about your wishes is key to ensuring they are honored.

Crucial Points on This Form

What is a California Living Will?

A California Living Will is a legal document where a person (the principal) can declare their wishes about medical treatment in situations where they are no longer capable of making decisions for themselves due to incapacity. It specifically addresses conditions under which life-sustaining treatment should or should not be provided.

Who should have a California Living Will?

Any adult who wants to have control over their medical treatment in the event they become incapacitated should consider having a Living Will. It's especially important for those with strong preferences about end-of-life care or those with serious health conditions.

How do I make a Living Will in California?

To make a Living Will in California, you would typically fill out a form that addresses your healthcare preferences in depth. This document should be witnessed by two individuals who meet certain requirements set by the state, indicating that the principal is acting by their free will. An alternative to witness signatures is having the document notarized. It’s recommended to consult with a healthcare attorney to ensure the document meets all legal requirements and accurately reflects your wishes.

Is a Living Will the same as a Power of Attorney for Health Care in California?

No, they are not the same. A Living Will specifically outlines your wishes regarding life-sustaining treatment if you're unable to make decisions for yourself. A Power of Attorney for Health Care, on the other hand, appoints someone else (an agent) to make healthcare decisions on your behalf. It's broader in scope, covering any health care decision, not just those about life-sustaining treatment. Many people have both documents to fully cover their health care preferences.

Common mistakes

When filling out the California Living Will form, individuals often make mistakes that can create confusion or lead to unintended results regarding their healthcare choices. Recognizing and avoiding these mistakes ensures that the document accurately reflects the person's wishes and complies with California state requirements.

  1. Not being thorough with specific medical wishes: People frequently miss providing detailed instructions for their health care, such as the types of life-sustaining treatments they want or do not want.

  2. Failing to update the document: Individuals sometimes forget to update their Living Will following major life changes, which can make the document reflect outdated wishes.

  3. Not discussing their wishes with family and healthcare providers: A common error is not communicating the contents of the Living Will with family members and healthcare providers, leading to potential surprises or conflicts later on.

  4. Choosing an unsuitable person as an agent: Selecting someone who is not comfortable with or capable of making healthcare decisions can be a mistake.

  5. Leaving the form incomplete: Sometimes, individuals skip parts of the form or leave sections blank, leading to ambiguity.

  6. Overlooking the need for witnesses or notary: The absence of properly executed witnessing or notarization, as required by California law, invalidates the document.

  7. Using unclear language: People often use language that is open to interpretation, which can complicate understanding the document's intent.

  8. Lacking a backup agent: Not naming an alternate agent can result in no one being authorized to make decisions if the primary agent is unable or unwilling to do so.

  9. Ignoring legal requirements: Individuals sometimes overlook state-specific requirements, such as witness qualifications or the definition of what constitutes a legal Living Will in California.

Avoiding these common errors helps ensure that the California Living Will clearly and effectively communicates a person's healthcare preferences, providing peace of mind to themselves and their loved ones.

Documents used along the form

A California Living Will is an important document that allows you to express your wishes regarding medical treatment in the event that you are no longer able to communicate those wishes yourself. It's a crucial part of planning for the future, but it doesn't exist in isolation. To ensure a comprehensive approach to your healthcare and end-of-life decisions, a few other forms and documents should be considered alongside it. These documents complement the Living Will by covering aspects that it might not, providing a more complete legal and personal directive.

  • Durable Power of Attorney for Healthcare: This document appoints someone you trust to make healthcare decisions on your behalf if you become unable to do so. Unlike a Living Will, which only covers the refusal or request of life-sustaining treatment, this Power of Attorney enables your agent to make broader healthcare decisions based on your wishes.
  • Physician Orders for Life-Sustaining Treatment (POLST): For individuals with serious illnesses, a POLST form compliments a Living Will by translating your end-of-life wishes into medical orders that are immediately actionable by healthcare providers. This ensures that your treatment preferences are followed even before hospitalization or in emergency situations.
  • Do Not Resuscitate (DNR) Order: A DNR is a medical order that tells healthcare professionals not to perform CPR in case your breathing stops or if your heart stops beating. It's specific to the refusal of CPR and does not address other treatments. Having a DNR in place can be crucial for those who have strong feelings about not wanting resuscitative measures taken.
  • Last Will and Testament: While not directly related to medical decisions, your Last Will and Testament dictates how you would like your assets and personal matters handled after your death. It's an essential component of estate planning, ensuring your wishes are respected and carried out concerning your property and personal effects.

Together, these documents provide a framework for communicating your healthcare and personal wishes. The California Living Will ensures your voice is heard regarding medical treatment at the end of life, while the accompanying forms ensure your broader healthcare and personal decisions are respected. Proper planning with these documents can bring peace of mind to you and clarity to your loved ones and healthcare providers.

Similar forms

  • Last Will and Testament: Similar to a Living Will, the Last Will and Testament allows individuals to outline their wishes regarding the distribution of their assets after they pass away. While the Living Will focuses on healthcare decisions during the individual’s lifetime, particularly toward the end, the Last Will and Testament deals with financial and property matters after death.

  • Durable Power of Attorney for Healthcare: This document complements a Living Will by appointing a specific person to make healthcare decisions on the individual's behalf if they are unable to communicate their wishes. Both documents work together to ensure that healthcare preferences are honored.

  • General Durable Power of Attorney: Similar to a Living Will in its purpose of planning for future incapacity, this document allows an individual to appoint someone to make financial decisions on their behalf, rather than healthcare decisions.

  • Healthcare Proxy: Closely related to a Living Will, a healthcare proxy appoints a trusted person to make healthcare decisions if the individual becomes incapable of making those decisions. The main difference is that a healthcare proxy may come into effect under different circumstances than those specified in a Living Will.

  • Advance Healthcare Directive: This term is often used interchangeably with Living Will. Both documents allow individuals to specify their wishes for medical treatment in the event that they are no longer able to express informed consent due to illness or incapacity.

  • Do Not Resuscitate (DNR) Order: A DNR is a medical order that tells healthcare professionals not to perform CPR if an individual's breathing stops or if the heart stops beating. It is similar to a Living Will in that it expresses an individual's healthcare preferences, but it is more specific and is used in emergency medical situations.

  • Organ Donation Registry Form: Similar to a Living Will in the aspect of planning for unforeseen health scenarios, an Organ Donation Registry Form allows individuals to express their wishes regarding organ donation after death.

  • Five Wishes Document: Similar to a Living Will, the Five Wishes Document is an advance directive that covers personal, spiritual, medical, and legal wishes at the end of life. It is a comprehensive document that allows individuals to outline their preferences in detail.

  • Trust: Although primarily a financial planning tool used to manage assets during an individual’s life and distribute them after their death, a Trust is related to a Living Will in its forward-looking nature, planning for the welfare of the individual and their beneficiaries.

Dos and Don'ts

When preparing the California Living Will form, it's important to approach the task with care and diligence. Below are several dos and don’ts that can help guide you through the process efficiently and effectively.

Dos:

  1. Read all instructions carefully before beginning. Understand every section and what is required of you.

  2. Be clear and specific about your medical treatment preferences. This clarity will guide your healthcare providers in accordance with your wishes.

  3. Include your full legal name, the date, and other identifying information as required to ensure the document is legally recognized.

  4. Discuss your decisions with your healthcare provider and a trusted family member or friend. This ensures that those involved are aware of your wishes and can advocate on your behalf.

  5. Have the document properly witnessed or notarized, following the specific requirements of California law to make it legally binding.

  6. Keep the original document in a safe but accessible place. Inform your healthcare proxy, family, or close friends where it is kept.

  7. Review and update your Living Will regularly, especially after any significant life changes or changes in your health condition.

Don'ts:

  • Do not leave any sections blank. If a section does not apply, clearly mark it as “N/A” (not applicable) to show you did not overlook it.

  • Avoid using ambiguous language that could confuse healthcare providers or loved ones. Be as explicit as possible.

  • Do not forget to sign and date the document. An unsigned Living Will is not legally effective.

  • Avoid keeping your Living Will a secret from your family or healthcare proxy. Communication is key to ensuring your wishes are followed.

  • Do not use a generic form without verifying it meets California's requirements. State laws vary, and non-compliance may render it invalid.

  • Do not assume that doctors will automatically know your wishes or have access to your Living Will. Make it readily accessible to those involved in your care.

  • Do not neglect to appoint a healthcare proxy or durable power of attorney for health care to ensure someone can advocate for your preferences if you're unable to communicate.

Misconceptions

When considering healthcare decisions, many individuals encounter misconceptions about the California Living Will form. This document, vital for guiding medical care when a person is unable to communicate their wishes, is often misunderstood. Here, we tackle seven common misconceptions to provide clarity.

  • It is only for the elderly or terminally ill. A widespread misconception is that only individuals who are elderly or have been diagnosed with a terminal illness need a Living Will. However, unexpected medical situations can arise at any age, making it important for adults of all ages to consider their preferences for medical treatment in advance.

  • A Living Will is difficult to revoke or change. The reality is that an individual can update or revoke their Living Will at any time, provided they are of sound mind. Changes in health, personal relationships, or preferences can necessitate a review and revision of the document to ensure it still reflects the person’s current wishes.

  • Discussions with family about the contents of a Living Will are unnecessary. On the contrary, discussing your Living Will with family members is crucial. These conversations ensure that your loved ones understand your wishes and can advocate for them, reducing confusion and conflict in potentially stressful situations.

  • Hospital staff always honor a Living Will. While a Living Will is legally binding, challenges can arise. In some cases, healthcare providers may be unaware of its existence, or there might be personal beliefs that cause reluctance to follow the directives. Ensuring the document is easily accessible and discussing wishes with healthcare providers can help mitigate these issues.

  • A Living Will covers all healthcare decisions. This document specifically addresses end-of-life care, such as the use of life-sustaining treatments. It does not cover other types of healthcare decisions, which are typically managed by a Healthcare Power of Attorney. It’s important to have both documents to fully address potential healthcare decisions.

  • A lawyer is required to create a valid Living Will. While consulting with a legal professional can be helpful, particularly for complex situations, California provides forms that individuals can complete on their own. These forms are designed to be legally valid once they are properly filled out, signed, and witnessed or notarized.

  • Living Wills are only effective within California. Many people believe that a Living Will is only valid in the state where it was created. However, most states have laws recognizing documents created in other states, provided they comply with the original state’s laws. It’s wise to review a Living Will if you move to ensure it meets your new home state’s requirements.

Key takeaways

When considering the completion and use of the California Living Will form, it's important to keep in mind several key points to ensure that your health care wishes are clearly understood and can be legally followed. Here are five critical takeaways:

  • Understanding the Purpose: The California Living Will, also known as an Advance Health Care Directive, allows individuals to outline their preferences for medical treatment in situations where they are unable to make decisions for themselves. This document can specify desires for life-sustaining treatments and end-of-life care.
  • Legal Requirements: To ensure the living will is legally binding, it must be completed in accordance with California law. This generally includes having the document signed in the presence of two eligible witnesses or a notary public. Certain individuals, such as your health care provider, cannot serve as witnesses.
  • Choosing an Agent: The form allows for the appointment of a health care agent. This person, also called a proxy or attorney-in-fact, is authorized to make medical decisions on your behalf if you're incapacitated. Choosing someone who understands your values and wishes is crucial.
  • Completeness: Clearly and thoroughly completing each section of the form is essential. Ambiguity in your living will can lead to confusion and delays in your healthcare. It is advisable to discuss your wishes and the details of the form with your health care agent, family, and physician.
  • Accessibility: Once the form is completed and signed, it's important to keep it accessible. Copies should be given to your health care agent, family members, primary care physician, and possibly a lawyer. You may also consider carrying a card in your wallet that indicates you have a living will and where it can be found.

By considering these takeaways, you can help ensure your health care preferences are respected and can guide your loved ones and healthcare providers during challenging times.

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