Official Living Will Template for the State of Virginia

A Living Will is an important document that outlines an individual's wishes regarding medical treatment in situations where they may not be able to communicate those wishes themselves. Several other documents serve similar purposes in terms of expressing healthcare preferences or appointing decision-makers. Here’s a list of eight documents that are similar to a Living Will:

• Advance Directive: This is a broader term that encompasses both Living Wills and Durable Powers of Attorney for Health Care. It allows individuals to outline their healthcare preferences and appoint someone to make decisions on their behalf.
• Durable Power of Attorney for Health Care: This document specifically designates a person to make healthcare decisions for someone if they become incapacitated, focusing more on appointing a decision-maker rather than stating treatment preferences.
• Do Not Resuscitate (DNR) Order: A DNR order instructs medical personnel not to perform CPR if a person’s heart stops or they stop breathing. It is often used in conjunction with a Living Will.
• Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order that outlines a patient’s preferences for treatment in emergency situations. It is typically used for patients with serious illnesses.
• Health Care Proxy: Similar to a Durable Power of Attorney for Health Care, this document appoints someone to make medical decisions on behalf of the individual, but it may not include specific treatment preferences.
• Personal Health Care Plan: This document outlines an individual’s overall healthcare goals and preferences, including treatments they do or do not wish to receive.
• NYCERS F170 Form: This form is essential for eligible Tier 1, Tier 2, and Tier 4 members of the New York City Employees' Retirement System (NYCERS) who want to opt into the optional 25-Year Retirement Program for Emergency Medical Technicians. Members can find more information on the application process at nyforms.com/nycers-f170-template/.
• End-of-Life Care Plan: This plan focuses specifically on preferences for care during the final stages of life, detailing what types of interventions or comfort measures should be taken.
• Organ Donation Document: While not directly related to medical treatment preferences, this document expresses an individual’s wishes regarding organ donation, which can be an important aspect of end-of-life planning.

Each of these documents plays a vital role in ensuring that individuals’ healthcare preferences are honored, especially during critical moments when they may not be able to speak for themselves.

Here are key takeaways regarding the Virginia Living Will form:

1. Understand the purpose: A Living Will outlines your wishes regarding medical treatment if you become unable to communicate.
2. Eligibility: Any adult resident of Virginia can create a Living Will.
3. Clear instructions: Specify your preferences for life-sustaining treatments, such as resuscitation and artificial nutrition.
4. Sign and date: The form must be signed and dated by you to be valid.
5. Witness requirement: At least two witnesses must sign the document, confirming that you are of sound mind and not under duress.
6. Notarization: While notarization is not required, it can add an extra layer of validation.
7. Keep copies: Store the original in a safe place and provide copies to your healthcare provider and family members.
8. Review regularly: Revisit your Living Will periodically to ensure it still reflects your wishes.
9. Communicate your wishes: Discuss your decisions with family and healthcare providers to ensure they understand your preferences.

Instructions on How to Fill Out Virginia Living Will

Completing the Virginia Living Will form is an important step in expressing your healthcare wishes. After filling out the form, you will need to ensure that it is signed and witnessed properly to be legally valid. Here are the steps to guide you through the process of filling out the form.

1. Begin by downloading the Virginia Living Will form from a reliable source or obtain a hard copy from a legal office.
2. Read the instructions carefully to understand the sections of the form.
3. Fill in your full name at the top of the form. Ensure that it matches your identification documents.
4. Provide your address, including city, state, and zip code.
5. Indicate your date of birth. This information helps to confirm your identity.
6. In the section regarding your healthcare preferences, clearly state your wishes regarding life-sustaining treatments. Be specific about what you do or do not want.
7. If there are any specific conditions or situations you want to address, include those details in the designated area.
8. Designate a healthcare agent if you wish to appoint someone to make decisions on your behalf. Provide their name and contact information.
9. Review the completed form for accuracy. Ensure that all sections are filled out as required.
10. Sign and date the form at the bottom. Your signature indicates that you understand and agree to the contents of the document.
11. Have at least two witnesses sign the form. They must be adults and cannot be your healthcare provider or related to you.
12. Make copies of the signed form for your records and for your healthcare agent.