Virginia Living Will

I. Declaration of Intent

I, [YOUR NAME], residing at [YOUR COMPANY ADDRESS], being of sound mind and understanding the importance of making my healthcare preferences known, hereby declare this document to be my Virginia Living Will.

II. Statement of Medical Preferences

If I am unable to communicate my wishes regarding medical treatment due to incapacity or terminal illness, I hereby express my preferences as follows:

1. End-of-Life Care:

   • Prioritize comfort and dignity.

   • CPR only if the a chance of meaningful recovery.

   • Ventilation if potential for quality life.

   • Accept artificial nutrition if chance of recovery.

   • Open to dialysis if it improves the quality of life.

   • Other invasive procedures for comfort only.

   • Request palliative care and hospice when appropriate.

2. Decision Making:

   • Value collaborative decision-making.

   • Designate [Name of Healthcare Agent] as a healthcare decision-maker.

III. End-of-Life Care Preferences

I understand that there may come a time when my condition is terminal and death is imminent. In such circumstances, I request the following regarding end-of-life care:

1. I request that all measures be taken to keep me comfortable and alleviate pain.

2. I do/do not wish to receive life-sustaining treatments, including but not limited to:

   • Cardiopulmonary resuscitation (CPR)

   • Mechanical ventilation

   • Artificial nutrition and hydration

   • Dialysis

   • Other invasive procedures

3. I wish to receive/decline palliative care and hospice services to ensure a comfortable and dignified end-of-life experience.

IV. Additional Instructions

Any additional instructions or specific preferences regarding medical treatment or end-of-life care not covered in this document are as follows:

1. Pain Management: Prioritize pain relief.

2. Spiritual and Emotional Support: Ensure access to spiritual guidance and counseling.

3. Personal Comfort: Maintain dignity and privacy.

4. Communication: Keep me informed; utilize alternative communication methods if needed.

5. Family Involvement: Involve the designated healthcare agent and family in decision-making.

6. Cultural/Religious Considerations: Respect and accommodate cultural/religious beliefs.

7. Funeral Preferences: Specify funeral arrangements and burial/cremation wishes.

V. Appointment of Healthcare Agent

If I am unable to make medical decisions for myself, I hereby designate the following individual(s) as my healthcare agent(s) to make healthcare decisions on my behalf:

• Name of Healthcare Agent: [Full Name]

• Relationship to Testator: [Relationship]

• Contact Information: [Phone Number, Email Address]

VI. Revocation of Prior Documents

I hereby revoke any prior Living Will or Advance Directive that I have previously executed.

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VII. Signature and Witness

I sign this document on this [DATE] in the presence of the following witnesses, who attest to my signing of this Virginia Living Will:

Testator

[YOUR NAME]

[YOUR COMPANY ADDRESS]

Witness #1

Name: [WITNESS NAME 1]

Address: [WITNESS ADDRESS 1]

Witness #2

Name: [WITNESS NAME 2]

Address: [WITNESS ADDRESS 2]

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VIII. Notarization (optional)

This Living Will may be notarized for additional legal validity, though it is not required by Virginia law.

Notary Public Name: [NOTARY'S NAME]

Commission Expires: [EXPIRATION DATE]

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