Ohio Living Will Template
This Living Will is made in accordance with Ohio Revised Code Section 2133.01 to 2133.99.
I, [Your Full Name], residing at [Your Address], in the City of [City], County of [County], State of Ohio, being of sound mind, do hereby declare this as my Living Will.
This Living Will expresses my wishes regarding medical treatment in the event that I am unable to communicate my wishes regarding my healthcare.
In the event that I am diagnosed with a terminal condition, or I am in a state of permanent unconsciousness, I wish to make the following choices:
- If I cannot be cured or my life cannot be prolonged in a way that is acceptable to me, I request that life-sustaining treatment be withheld or withdrawn.
- I do not wish to receive artificial nutrition and hydration as part of my treatment.
- Should I be in a state of permanent unconsciousness, I do not wish for any life-sustaining treatments to be administered.
If I have appointed a healthcare power of attorney (POA), my POA is [Name of POA] and can be contacted at [POA's Phone Number].
Additionally, I may provide alternative instructions below:
[Additional Instructions or Preferences]
This Living Will expresses my wishes and will be honored by my healthcare providers.
Signed this [Date] day of [Month, Year].
Signature: ______________________
Printed Name: [Your Full Name]