Oregon Living Will
This Oregon Living Will is a legal document that sets forth your wishes regarding medical treatment in the event that you are unable to communicate or make decisions due to incapacity or terminal illness. It is designed in accordance with the Oregon Advance Directive laws specified in the Oregon Revised Statutes, sections 127.505 to 127.660 and 127.995. By completing this document, you are ensuring that your medical care preferences are understood and respected by your family and healthcare providers.
Personal Information
Full Name: ___________________________
Date of Birth: ________________________
Address: ______________________________
City: __________________________________
State: Oregon
Zip Code: ____________________________
Living Will Declarations
This section outlines your wishes regarding life-sustaining treatments, artificial nutrition and hydration, and other medical interventions. Please indicate your preferences clearly.
Life-sustaining Treatments: In the event of a terminal condition where recovery is not expected, I wish to:
- Receive all available treatments, extending life for as long as possible.
- Limit certain treatments, as specified: ________________________________________
- Refuse all treatments, allowing natural death to occur.
Artificial Nutrition and Hydration: If I am unable to take food or water by mouth, I wish to:
- Receive artificially provided food and water.
- Refuse artificially provided food and water, allowing death to occur naturally.
Other Medical Interventions: Please specify any other medical interventions you want or do not want, such as ventilation, dialysis, antibiotics, etc.
________________________________________________________________________
________________________________________________________________________
Signature and Witnesses
I, ________________ (Your Full Name), declare this document to be my Living Will. I am of sound mind and understand the nature and implications of this document. This Living Will reflects my personal, conscious, and free wishes.
Date: ____________
Your Signature: ______________________________________
Witnesses: This Living Will was signed in the presence of two witnesses, who are not related to the declarant by blood or marriage, and are not entitled to any portion of the declarant’s estate upon death.
- Name: _______________________ Date: ____________ Signature: ___________________________
- Name: _______________________ Date: ____________ Signature: ___________________________