Table of Contents
The Illinois Living Will form serves as a crucial legal document that allows individuals to express their wishes regarding medical treatment in situations where they may be unable to communicate their preferences due to illness or incapacitation. This form specifically addresses end-of-life decisions, enabling individuals to outline their desires concerning life-sustaining treatments, such as resuscitation efforts, artificial nutrition, and hydration. By completing this document, individuals can designate a trusted agent to make healthcare decisions on their behalf, ensuring that their values and preferences are honored even when they cannot advocate for themselves. The form requires clear articulation of one’s wishes, and it must be signed in the presence of witnesses to be legally binding. Additionally, the Illinois Living Will is designed to facilitate discussions among family members and healthcare providers, promoting transparency and understanding in what can often be an emotionally charged context. Overall, this form empowers individuals to take control of their healthcare decisions, providing peace of mind for both the individual and their loved ones.
Example - Illinois Living Will Form
Illinois Living Will Template
This document serves as a Living Will, directed in accordance with the Illinois Living Will Act (755 ILCS 35/1 et seq.), allowing individuals to control decisions relating to their own health care, including the decision to have death-delaying procedures withheld or withdrawn in instances where death is imminent.
Principal Information
The undersigned, herein referred to as the "Principal," hereby affirms the following personal details:
Full Name: _________________________
Address: ___________________________
City: _____________________________
State: Illinois
Zip Code: _________________________
Date of Birth: _____________________
Social Security Number: ____________
Living Will Declaration
I, _________________________ (the Principal), being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, hereby declare that:
- If at any time I should have an incurable and irreversible injury, disease, or illness judged to be a terminal condition by the attending physician who has determined that my death is imminent except for death-delaying procedures, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally.
- I understand the full import of this decision, and I am emotionally and mentally competent to make this decision.
- In the absence of my ability to give directions regarding the use of such death-delaying procedures, I intend that my family, doctors, and any other individuals making decisions on my behalf shall be guided by this directive.
Signature
This Living Will shall be in effect until it is revoked. I understand that I may revoke this directive at any time, in any manner without regard to my mental or physical condition. This Living Will is voluntary and I understand that I am not required to have a Living Will by anyone.
Principal's Signature: _________________________ Date: ____________
Witness Declaration
This Living Will was signed in my presence by the Principal who appears to be of sound mind and under no duress, fraud, or undue influence.
First Witness
Name: _________________________
Address: ______________________
City: _________________________
State: ________________________
Zip Code: _____________________
Signature: _____________________ Date: ____________
Second Witness
Name: _________________________
Address: ______________________
City: _________________________
State: ________________________
Zip Code: _____________________
Signature: _____________________ Date: ____________
Additional Declarations
If you wish to include additional instructions about your health care, do so here:
____________________________________________________________________________
____________________________________________________________________________
Although this Illinois Living Will Template is designed to be comprehensive, it is important to consult with a health care professional or a lawyer to ensure that it meets all your individual needs and complies with current Illinois laws.
PDF Form Properties
| Fact Name | Details |
|---|---|
| Governing Law | The Illinois Living Will is governed by the Illinois Compiled Statutes, Chapter 755, Act 35. |
| Purpose | This form allows individuals to express their wishes regarding medical treatment in case they become unable to communicate. |
| Eligibility | Any adult who is at least 18 years old can create a Living Will in Illinois. |
| Requirements | The form must be signed by the individual and witnessed by two adults or notarized. |
| Revocation | A Living Will can be revoked at any time by the individual, either verbally or in writing. |
| Healthcare Decisions | The document specifically addresses decisions about life-sustaining treatment, including resuscitation and artificial nutrition. |
| Distribution | It is recommended to provide copies of the Living Will to family members and healthcare providers to ensure it is honored. |
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