Attorney-Verified Living Will Form for the State of Oklahoma

Oklahoma Living Will Template

This Living Will is established according to the Oklahoma Advance Directive Act. It is designed to express the desires regarding medical treatment of the undersigned in scenarios where the ability to communicate these desires is lost.

Part 1: Personal Information

• Full Name: ________________________
• Date of Birth: ________________________
• Address: ________________________
• City: ________________________ State: Oklahoma Zip Code: ____________
• Phone Number: ________________________

Part 2: Health Care Directives

In the event that I am unable to make my own medical decisions, I provide the following instructions:

1. If I am in a terminal condition, I direct that my life not be extended by life-sustaining treatment, except that if I am unable to take food or water by mouth, I wish to receive hydration and nutrition artificially, unless I specify otherwise below.
2. If I am in a persistent vegetative state, I direct that life-sustaining treatment be withheld or withdrawn.
3. If I am unable to communicate and have an end-stage condition, I direct that all treatments which only prolong the process of dying be withheld or withdrawn and that I be permitted to die naturally.
4. I may add additional directives or limitations regarding my health care here: __________________________________________________________

Part 3: Signature

I understand that this living will represents my directives as of the date signed. I am mentally capable of making my own health care decisions at the time of this document's creation. This Living Will remains effective until I revoke it.

Date: ___________________

Signature: ___________________

Part 4: Witness Statement

This section must be completed for the Living Will to be valid in Oklahoma. The witness cannot be someone who is related to you by blood, marriage, or adoption; entitled to any portion of your estate; financially responsible for your medical care; or directly involved in your health care. Two witnesses are required.

• Witness 1 Name: ________________________
• Witness 1 Signature: ________________________ Date: ________________
• Witness 2 Name: ________________________
• Witness 2 Signature: ________________________ Date: ________________

By signing above, we declare that the person signing this Oklahoma Living Will did so in our presence and appears to be of sound mind and free of duress. We affirm that we meet the qualifications to act as witnesses as defined by the Oklahoma Advance Directive Act.