Georgia Living Will
This Living Will is created under the Georgia General Assembly legislation, specifically following the guidelines established for advance directives in the state of Georgia.
I, [Your Full Name], of [Your Address], residing in [City, State, ZIP Code], make this Living Will to express my wishes regarding medical treatment in the event I am unable to communicate my decisions.
Date of Birth: [MM/DD/YYYY]
If I become unable to make my own health care decisions, I direct my health care providers to follow these instructions:
- If I am diagnosed with a terminal condition, or if I am in a persistent vegetative state, I do not want life-sustaining treatment to be provided if it would only prolong the dying process.
- If I am unable to express my wishes, I want the following treatment options available to me:
- Resuscitation: [Yes/No]
- Mechanical ventilation: [Yes/No]
- Feeding tubes: [Yes/No]
- Pain relief measures: [Yes/No]
- I wish to be kept as comfortable as possible. I want all necessary measures taken to relieve pain, even if such measures may hasten my death.
- I designate the following individual to make decisions about my healthcare if I am unable to communicate: [Name of Agent], residing at [Agent's Address].
This Living Will reflects my wishes about my healthcare and I am signing it voluntarily, in the presence of the witnesses listed below.
Signed this [Date] by [Your Signature].
Witnessed by:
- Signature: ______________________ Name: [Witness 1 Name] Address: [Witness 1 Address]
- Signature: ______________________ Name: [Witness 2 Name] Address: [Witness 2 Address]