North Dakota Living Will Template
This Living Will is intended to comply with the North Dakota Century Code Chapter 23-06.5 regarding advance directives. Please fill in the information in the blanks provided below.
I, [Your Full Name], residing at [Your Address], in the state of North Dakota, declare this to be my Living Will.
This Living Will expresses my wishes regarding medical treatment in the event I am unable to communicate due to a terminal condition or irreversible coma.
1. Directions for Health Care:
- If I am diagnosed with a terminal condition, I do not want life-sustaining procedures to be used to prolong my life.
- If I am in an irreversible coma, I do not wish to receive artificial nutrition and hydration.
- I wish to receive comfort care to maintain my quality of life.
- If I have any other preferences, they are as follows: [Your Preferences].
2. Appointment of Health Care Agent:
If I am unable to make health care decisions, I appoint the following person as my health care agent:
Name: [Agent's Full Name]
Address: [Agent's Address]
Phone: [Agent's Phone Number]
3. Signatures:
Signature: [Your Signature]
Date: [Date]
4. Witnesses:
This Living Will must be signed in the presence of two witnesses who are not related to me or entitled to my estate:
- Witness 1: [Witness 1 Name], Signature: [Witness 1 Signature], Date: [Date]
- Witness 2: [Witness 2 Name], Signature: [Witness 2 Signature], Date: [Date]
This document reflects my desires regarding medical treatment and care. Make sure it is shared with my family, my health care agent, and my medical provider.