Valid  Living Will Template for New Jersey

Valid Living Will Template for New Jersey

A New Jersey Living Will is a legal document that outlines an individual’s preferences regarding medical treatment in the event they become unable to communicate their wishes. This form is essential for ensuring that your healthcare choices are respected, particularly in situations involving terminal illness or incapacitation. Understanding its significance can provide peace of mind for both you and your loved ones.

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In New Jersey, the Living Will form serves as a crucial document that allows individuals to express their healthcare preferences in the event they become unable to communicate their wishes. This legally binding directive outlines specific medical treatments that a person wishes to receive or decline, particularly in situations involving terminal illness or irreversible conditions. By completing this form, individuals can ensure that their values and desires regarding end-of-life care are respected, even when they cannot voice them. The Living Will not only provides clarity for healthcare providers but also offers peace of mind to family members, who may otherwise face difficult decisions during emotionally challenging times. Importantly, this document can be tailored to reflect personal beliefs about life-sustaining treatments, such as resuscitation efforts, mechanical ventilation, and nutritional support. Understanding the components of the New Jersey Living Will form is essential for anyone seeking to take control of their healthcare decisions and to communicate their preferences effectively to loved ones and medical professionals alike.

New Jersey Living Will Sample

New Jersey Living Will Template

This Living Will is created in accordance with New Jersey law N.J.S.A. 26:2H-53 through 26:2H-61. It outlines your wishes regarding medical treatment in the event you become unable to communicate those wishes.

Personal Information

  • Full Name: ___________________________
  • Date of Birth: ________________________
  • Address: ______________________________
  • City: _________________________________
  • State: ________________________________
  • Zip Code: _____________________________

Healthcare Proxy

I hereby designate the following individual as my healthcare proxy:

  • Name of Healthcare Proxy: ________________________
  • Address: ______________________________________
  • Phone Number: _________________________________

Living Will Declaration

If I am diagnosed with a terminal condition or am in a persistent vegetative state, I wish to make my healthcare decisions clear. I do not want the following types of treatment under these circumstances:

  • Cardiopulmonary resuscitation (CPR)
  • Mechanical ventilation
  • Artificial nutrition and hydration
  • Other: ______________________________________

Signature

I understand that this document reflects my wishes regarding my medical care. I have signed this Living Will voluntarily and of my own free will.

Signature: _____________________________

Date: _________________________________

Witness Statement

We, the undersigned witnesses, affirm that the person signing this document is known to us, appears to be of sound mind, and is voluntarily signing this Living Will.

  • Witness 1 Name: ________________________
  • Witness 1 Signature: ____________________
  • Date: _________________________________
  • Witness 2 Name: ________________________
  • Witness 2 Signature: ____________________
  • Date: _________________________________

Key takeaways

When considering a New Jersey Living Will, it's important to understand its purpose and how to properly complete the form. Here are some key takeaways:

  • A Living Will outlines your preferences for medical treatment in case you become unable to communicate your wishes.
  • New Jersey law allows you to specify what types of life-sustaining treatments you want or do not want.
  • You must be at least 18 years old and of sound mind to create a valid Living Will.
  • It is advisable to discuss your wishes with family members and healthcare providers before completing the form.
  • Once completed, the Living Will should be stored in a safe place, and copies should be shared with your healthcare proxy and family.
  • Review your Living Will periodically to ensure it still reflects your wishes, especially after major life changes.