Wyoming Living Will
I. Declaration
I, [YOUR NAME], residing at [YOUR COMPANY NAME], being of sound mind and acting of my own free will, do hereby declare this document to be my Living Will, directing the course of my medical treatment and end-of-life care if I am unable to communicate my wishes.
II. Statement of Intent
I understand that medical circumstances may arise where I am unable to make decisions regarding my healthcare.
I intend to express my preferences regarding life-sustaining treatments in advance to guide my healthcare providers and family members.
III. Directive
Following my beliefs and desires, I hereby direct that:
If I am diagnosed with a terminal condition and am unable to communicate my wishes, I do not wish to receive life-prolonging treatments that only serve to artificially prolong the process of dying.
Specifically, I do not consent to the use of:
Ventilator or mechanical breathing assistance.
Artificial hydration through intravenous fluids or feeding tubes.
Feeding tubes for artificial nutrition.
I understand that this directive applies even if the absence of such treatments may hasten my death.
IV. Healthcare Proxy
If I am unable to make medical decisions for myself, I designate the following individual to serve as my healthcare proxy and make healthcare decisions on my behalf:
Name of Healthcare Proxy: [Full Name]
Relationship to Me: [Relationship]
Contact Information: [Phone Number, Email Address]
Name of Alternate Healthcare Proxy (optional): [Full Name]
Relationship to Me: [Relationship]
Contact Information: [Phone Number, Email Address]
V. Revocation
I hereby revoke any prior Living Will or Advance Directive that I may have executed.
VI. Signature and Witnesses
I sign this Living Will on this [DATE] in the presence of the following witnesses, who attest to my signature in their presence and at my request:
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]
VII. Notarization (Optional)
Acknowledged before me on [DATE] by [YOUR NAME], the declarant, and witnessed by the undersigned witnesses
Notary Public Name: [NOTARY'S NAME]
Commission Expires: [EXPIRATION DATE]
Will Templates @ Template.net
