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Form #706Living Will for Arizona
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Arizona Living Will - Free Legal Form
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Arizona.
Living
Will
Some general statements concerning your health care
options are outlined below. If you agree with one of the statements, you should
initial that statement. Read all of these statements carefully before you
initial your selection. You can also write your own statement concerning
life-sustaining treatment and other matters relating to your health care. You
may initial any combination of paragraphs 1, 2 and 3, but if you initial
paragraph 4 the others should not be initialed.)
_________ 1. If I have a terminal condition I do not
want my life to be prolonged and I do not want life-sustaining treatment,
beyond comfort care, that would serve only to artificially delay the moment of
my death.
_________ 2. If I am in a terminal condition or an
irreversible coma or a persistent vegetative state that my doctors reasonably
feel to be irreversible or incurable, I do want the medical treatment necessary
to provide care that would keep me comfortable, but I do not want the
following:
_________ (a) Cardiopulmonary resuscitation, for
example, the use of drugs, electric shock and artificial breathing.
_________ (b) Artificially administered food and
fluids.
_________ (c) To be taken to a hospital if at all
avoidable.
_________ 3. Notwithstanding my other directions, if I
am known to be pregnant, I do not want life-sustaining treatment withheld or
withdrawn if it is possible that the embryo/fetus will develop to the point of
live birth with the continued application of life-sustaining treatment.
_________ 4. Notwithstanding by other directions I do
want the use of all medical care necessary to treat my condition until my
doctors reasonably conclude that my condition is terminal or is irreversible
and incurable or I am in a persistent vegetative state.
_________ 5. I want my life to be prolonged to the
greatest extent possible.
Other or additional statements of desires
I have _________ I have not _________ attached
additional special provisions or limitations to this document to be honored in
the absence of my being able to give health care directions.
_______________
Signature of Declarant
Date _________
Time _________
Witness _________
Address _________
Witness _________
Address _________
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by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
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