Michigan Living Will Template
This document serves as a Living Will in accordance with Michigan state laws. It allows you to outline your preferences regarding medical treatment in the event you become unable to communicate those wishes.
Declaration of Preferences:
To the best of my knowledge, I am of sound mind and not acting under duress. I hereby declare my wishes regarding medical treatment, as follows:
- My full name: ________________________________
- Date of birth: ________________________________
- Address: ____________________________________
- City, State, ZIP: ___________________________
If I am diagnosed with a terminal illness or my condition becomes irreversible, I wish for the following instructions to be followed:
- Withhold or withdraw life-sustaining treatment, including but not limited to:
- Ventilators
- Feeding tubes
- Cardiac resuscitation
- Provide comfort care, including pain relief, even if it may hasten my death.
- Other instructions (please specify): _____________________________________________
Designation of Patient Advocate:
If I become unable to make my own medical decisions, I designate the following individual as my patient advocate:
- Advocate's name: ________________________________
- Relationship to me: _____________________________
- Contact information: ___________________________
This Living Will reflects my healthcare preferences according to Michigan law and is valid until I revoke it in writing.
Please sign and date below:
- Signature: ____________________________________
- Date: ________________________________________
Witnesses:
- Witness #1 name: _____________________________
- Signature: ____________________________________
- Date: ________________________________________
- Witness #2 name: _____________________________
- Signature: ____________________________________
- Date: ________________________________________
This template provides a framework for you to express your wishes. It is recommended that you consult a legal professional for personalized guidance.