Print Project
GRACE's Living Will and Healthcare Surrogate Form
Print Living Will & Healthcare Surrogate Form -
Spanish
PDF files can be viewed with Adobe Acrobat Reader.
What States Require My Living Will to be
Notarized?
What to do with this Living Will / Advance Care Plan
Document?
Tell your closest relatives what is in the Advance Care Plan document.
Give a copy to your Spiritual Leader.
If you have a pre-existing Living Will or Advance Care Plan, destroy the old document and any existing copies and give copies of your new document to the above individuals.
Some States require an additional form to be completed if you do not want cardiopulmonary resuscitation (CPR) attempted. You should check with your health care provider or State health officials to find out if your State requires an additional form to prevent unwanted CPR (Do Not Attempt Resuscitation Form or "DNR" form).
"One important ingredient of the medical profession is a
firm commitment to the patient not to abandon them until the end.
It is what makes medicine such a great profession; Filled with joy
and sorrow, exhilaration and sadness, but always compassionate,
caring and altruistic. Its moral authority derives from the fact
that the patients' well-being is paramount from beginning to end."
-Lofty Basta, M.D., A GRACEful Exit
Copyright waived for individual use and downloading. The printed
version form is valid. If you wish an original form, please contact
Project GRACE.