A Vermont Living Will is a legal document that allows individuals to outline their preferences for medical treatment in case they become unable to communicate their wishes. This form ensures that your healthcare choices are respected, even when you cannot express them yourself. To take control of your future healthcare decisions, consider filling out the Vermont Living Will form by clicking the button below.
In the realm of personal healthcare decisions, the Vermont Living Will form stands as a vital tool for individuals wishing to express their medical treatment preferences in advance. This document empowers individuals to articulate their desires regarding life-sustaining treatments in the event they become unable to communicate their wishes due to illness or incapacitation. The form typically encompasses key elements such as the designation of a healthcare proxy, who will make decisions on the individual's behalf, and specific instructions about the types of medical interventions one wishes to receive or forgo. By filling out this form, residents of Vermont can ensure that their values and preferences are respected, providing peace of mind for both themselves and their loved ones. Furthermore, the Living Will serves to alleviate the burden on family members during emotionally challenging times, as it clarifies the individual's wishes and minimizes uncertainty in critical situations. Understanding the importance of this document can lead to more informed and thoughtful discussions about end-of-life care, emphasizing the significance of personal autonomy in healthcare choices.
Vermont Living Will Template
This Vermont Living Will is made in accordance with the Vermont Patient's Bill of Rights Act. It serves as a declaration of one's wishes regarding medical treatment in the event that they become incapable of making healthcare decisions.
Please fill in the blanks with the appropriate information:
I, ___________ [Your Full Name], a resident of ___________ [Your Full Address, City, Vermont, Zip Code], born on ___________ [Your Date of Birth], being of sound mind, do hereby willfully and voluntarily make known my desires regarding my healthcare treatment, should I become unable to participate in my medical care decisions.
In accordance with Vermont laws, I appoint the following individual as my healthcare agent:
Name: ___________
Relationship: ___________
Primary Phone: ___________
Alternate Phone: ___________
Should my appointed healthcare agent become unwilling, unable, or unavailable to act on my behalf, I appoint the following individual as my alternate healthcare agent:
In the event I am diagnosed with a terminal condition where the application of life-sustaining procedures would only serve to artificially prolong the process of dying, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure necessary to provide me with comfortable care.
I further direct that the following preferences about my healthcare be followed:
I understand that this declaration represents my directives and affirm that I understand the full import of this grant of powers to my agent.
This Living Will shall be in effect until revoked. I reserve the right to revoke or alter this document verbally or in writing at any time when I have the capacity to do so.
Signed on this ____ day of ___________ [Month], ______ [Year].
__________________________________
[Your Signature]
Printed Name: ___________
Witness Declaration:
This document was signed in my presence by the above-named individual who is personally known to me or who has provided satisfactory proof of identification. To the best of my knowledge, at the time of the signing, the declarant is of sound mind and under no duress, fraud, or undue influence.
Witness 1 Signature: ___________
Date: ___________
Witness 2 Signature: ___________
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