Colorado Living Will
Colorado Living Will
This Living Will is made by [Your Name] and outlines my wishes regarding medical treatment and end-of-life care should I become incapable of communicating my preferences. This document is by the laws of the State of Colorado.
I. Declaration
I, [Your Name], residing at [Your Address], being of sound mind and not under duress, fraud, or undue influence, do hereby declare this document to be my Living Will. I voluntarily direct and authorize my healthcare providers to carry out the wishes stated herein.
II. Appointment of Healthcare Agent
If I am unable to make my own healthcare decisions, I hereby appoint the following individual as my Healthcare Agent:
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Name: [Agent's Name]
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Relationship: [Relation to You]
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Address: [Agent's Address]
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Phone Number: [Agent's Phone Number]
The individual whom I have appointed as my Healthcare Agent, as identified in this document, will be given the authority to make all decisions related to my healthcare. These decisions, however, should be made in a manner that is consistent with the preferences and instructions that I have clearly expressed within this document. My Healthcare Agent's decisions should comply with my expressed choices.
III. Treatment Preferences
In situations where I am unable to communicate and am diagnosed with a terminal condition, or am permanently unconscious without hope of recovery, I direct that:
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I direct that if my situation cannot be improved or cured, any treatment that only serves to prolong my life and not to improve it, including artificially provided nutrition and hydration, should be withheld or withdrawn for my death to happen naturally.
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I request that I be provided with pain relief medication to ensure that I remain comfortable, regardless of the potential implications such as unjustly accelerating the event of my death.
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If my heart ceases to beat or I halt my breathing process, no efforts or attempts must be made to revive or resuscitate me. This is known as a "Do Not Resuscitate" instruction.
IV. Additional Directions
If I am unable to make my wishes known, I also wish the following to be considered (additional specifics can be added based on individual preference):
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Preference for hospice care:
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Yes
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No
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Location of care (home, hospice facility): [Preferred Location]
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Other wishes or directions: [Any Other Specific Wishes]
V. Execution
This Living Will will become effective and start to be enforced from the date it is signed. Once it has been initiated, this Living Will will continuously stay in force. This constant enforcement will persist indefinitely or until such time that there is a revision of it or it is completely revoked.
VI. Signature and Witness Declaration
We, the undersigned witnesses, each declare in the presence of [Your Name], who signed or acknowledged this as [His/Her] Living Will, that [He/She] appears to be of sound mind and not under duress, fraud, or undue influence.
[Your Name]
Witness 1:
[WITNESS 1 NAME]
[DATE SIGNED]
Witness 2:
[WITNESS 2 NAME]
[DATE SIGNED]
VII. Notarization
On this [DATE], before me, [NOTARY PUBLIC'S NAME], a notary public, personally appeared [Your Name], known to me (or satisfactorily proven) to be the person whose name is subscribed to this directive, and they acknowledged that they executed the same for the purposes therein contained.
Notary Public: [NOTARY PUBLIC'S NAME]
Commission Expires: [EXPIRATION DATE]
