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  • Living Will

    Living Will Form

    I, __________________________, being of sound mind and body, do not wish to be kept alive indefinitely by artificial means.

    Under no circumstances should my fate be put in the hands of pinhead politicians who couldn't pass ninth-grade biology if their lives depended on it or lawyers/doctors interested in simply running up the bills.

    If a reasonable amount of time passes and I fail to ask for at least one or more of the following (not necessarily in this order):

    ______a Bloody Mary

    ______a Margarita

    ______a Rum and Coke

    ______a Martini

    ______a Beer

    ______a Steak

    ______Lobster or crab legs

    ______The remote control

    ______a Bowl of ice cream

    ______The sports page

    ______Chocolate

    ______Sex


    It should then be presumed that I won't ever get better.

    When such a determination is reached, I hereby instruct my appointed person and attending physicians to pull the plug, reel in the tubes and call it a day.


    Signature: ___________________________

    Date: ___________________________
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