Indiana Living Will Form

Indiana Living Will Form

    Indiana living will template can be used to document the end-of-life decisions in the state of Indiana. This form helps people describe the procedure that you want to be followed if you are medically unable to convey those decisions yourself. The living will also protect your family members and loved ones from making tough decisions regarding health. Here we have prepared a free, easy-to-use and -edit Indiana living will form template that complies with the state laws.

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Indiana Living Will Form
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Indiana Living Will Form

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There is a growing norm to create a living will so people can convey their wishes in the end of life situations. However, different states have different laws regarding living wills, so it is important to make sure that your living will adheres to the local laws applicable.

If you want to create a living will in Indiana, you can use the Indiana living will form that CocoSign offers for free downloading. This form is designed keeping in mind the terms and conditions that govern living will in Indiana. Keep reading to know more about the Indiana living will form and the laws that apply to it:

What Is an Indiana Living Will?

Indiana living will form, also known as the Indiana living will declaration or Form 55316, is a document that details the end of life decisions of a person. This form helps people in describing the procedure that they want to be followed in case they are medically unable to convey those decisions themselves.

For example, if a person is in a coma and they would not like to live on life support, they can convey these wishes through the Indiana living will form. A person can make changes to their living will at any time by following the due procedure. There is also the provision for revoking the living will at any time required.

Download and use our Indiana living will template now!

What if you are medically unfit and want people to follow certain procedures? Use our Indiana living will template to document those decisions easily!

When Does an Indiana Living Will Become Effective?

In order for a living will to be effective in Indiana, the person who is signing the will should be of a sound mind. Additionally, there is a minimum age requirement for the person to be at least 18 years of age.

The will also need to be signed in the presence of two witnesses and it contains the witness signatures as well. The will remains effective till the time the declarant signs a new will or revokes the original one.

When and Why a Living Will is Needed?

A living will is required so a person can maintain a minimum dignity of life even when they cannot make their medical decisions themselves. Some people consider life-supporting medical processes such as tube feeding or ventilator support to be an unacceptable state of living.

In these cases, people have different wishes regarding how they want their medical treatment to follow. Since there is a possibility that they will not be in a state to make those decisions at that time, they can dictate those decisions beforehand through a living will form.

A living will form also makes sure that the loved ones of a person, such as their friends and family, do not have to make tough decisions that can take a toll on them mentally. These medical decisions can also create a conflict between the decision-makers at that time.

A pre-written living will eliminates this conflict by addressing what a person wants to be done during those times.

What Information Is Included in Indiana Living Will?

A living will form in Indiana must include the following:

Date: The living will form starts with the date on which the declarant is filling and signing the form.

Declarant Details: It is important to mention the correct legal name of the declarant. Full name is required while making sure no spelling errors occur.

Optional Clauses: The living will form contains various life-sustaining treatments and the declarant can choose to opt-out or opt-in for the treatments based on their preferences.

Additional Clauses: The declarant can also add their own custom preferences to life-sustaining situations they think might arise. It is recommended to fill this part only after discussing with a health physician first, in order to make sure the declarant is taking decisions that will benefit them.

Signatures: The form should contain the signature of the declarant in the end, along with the date of signing. Additionally, the form should also have the signatures of two witnesses with the date.

Download and use our Indiana living will template now!

What if you are medically unfit and want people to follow certain procedures? Use our Indiana living will template to document those decisions easily!

Endnotes

Creating an Indiana living will form is quite easy. The only requirement is to download the Indiana living will form template directly from CocoSign. In this template, you can fill in the required fields yourself.

CocoSign also offers a variety of other contracts, agreements, and form templates. Browse through CocoSign’s library and download any template that you see fit.

DOCUMENT PREVIEW

INDIANA LIVING WILL DECLARATION

 

Declaration made this                   day of                                      (month, year). I,  being at least eighteen (18) years of age and of sound mind, willfully and voluntarily make known my desires that my dying shall not be artificially prolonged under the circumstances set forth below, and I declare:

If at any time my attending physician certifies in writing that: (1) I have an incurable injury, disease, or illness; (2) my death will occur within a short time; and (3) the use of life prolonging procedures would serve only to artificially prolong the dying process, 

I direct that such procedures be withheld or withdrawn and that I be permitted to die naturally with only the performance or provision of any medical procedure or medication necessary to provide me with comfort care or to alleviate pain, and, if I have so indicated below, the provision of artificially supplied nutrition and hydration. (Indicate your choice by initialing or making your mark before signing this declaration.):

 

          I wish to receive artificially supplied nutrition and hydration, even if the effort to sustain life is futile or excessively burdensome to me.

 

          I do not wish to receive artificially supplied nutrition and hydration, if the effort to sustain life is futile or excessively burdensome to me.

 

          I intentionally make no decision concerning artificially supplied nutrition and hydration, leaving the decision to my health care representative appointed under IC 16-36-1-7 or my attorney in fact with health care powers under IC 30-5-5.

 

In the absence of my ability to give directions regarding the use of life prolonging procedures, it is my intention that this declaration be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and accept the consequences of the refusal.

 

I understand the full import of this declaration.

 

 

Signed                                       

 

 


City, County, and State of Residence

 

WITNESSES

 

The declarant has been personally known to me and I believe (him/her) to be of sound mind. I did not sign the declarant's signature above for or at the direction of the declarant. I am not a parent, spouse, or child of the declarant.  I am not entitled to any part of the declarant's estate or directly financially responsible for the declarant's medical care. I am competent and at least eighteen (18) years of age.

 

Witness                                 Date (month, day, year)                     

 

Witness                                 Date (month, day, year)                     

 

 

 

 

 

 

 

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