Arizona Living Will Form

One of the most important documents during the end-of-life process is an Arizona living will. When an individual is terminally sick and unable to express their wishes, a living will helps them convey their wishes. Using this form, health care providers may determine whether or not patients should receive life-saving measures like artificial respiration and feeding.

Arizona living will

Arizona Living Will Form

Laws and guidelines

Writing Instructions for Arizona Living Will

1st Article: Personal Details

(1) Name of Arizona's Principal. This text assumes that the Arizona patient who is writing out instructions for his or her medical treatment is doing it on his or her own. This means that, if you are the said patient in Arizona, please fill out the "My Information" box with your complete name as well as further information and contact information. To accurately identify the Principal sending this documentation, please include the Arizona Patient's details in this part while creating the document.

(2) Your Date of birth and Age

(3) The Declarant's Name, Address, and Phone Number in Arizona.

2nd Article: My End-of-Life Care Decisions

You may choose from the following statements: A, B, C, D, or E

(4) Care and Comfort Only. To ensure that he or she receives the medical care he or she is entitled to, the Arizona Principal must discuss the level of Arizona medical care he or she desires and is capable of when suffering a fatal disease or medical condition, or being in a coma for an extended period (unconscious). Statement A must be initialed if the patient consents to the treatment given so far it doesn’t extend the life and preserves the patient's comfort.

(5) Medical Treatment Restrictions. Using Statement B, the advantages of comfort care may be combined to extend one's life. Begin your statement by approving obtaining medical care but refusing undesirable treatments. If the Arizona Principal's situation warrants it, three more statements (numbered 1-3) enable the Arizona Principal to withhold particular treatment that is normally delivered. An Arizona Principal can reject all manner of CPR if Statement 1 is checked in the affirmative. Statement 2 can also permit the rejection of artificially supplied food and fluids (such as water), and Statement 3 should be checked if the Arizona Principal does not wish to be hospitalized except to manage the level of comfort and pain they are experiencing.

(6) Pregnancy Situations. This may be a concern if the Arizona Principal is still in her reproductive years. For example, When the Arizona Principal is rendered incapacitated by a terminal medical condition or permanent unconsciousness, but the embryo can survive and carry to full term, she may declare that she agrees to that. In such an instance, she should consent to Statement C.

(7) As Long As It Takes to Determine My Medical Condition. Even if the Arizona Principal has a pre-existing terminal disease, the cause of his or her incapacity may not be understood because of the complexity of certain medical disorders (i.e., cancer, leukemia, etc.). Statement D must be signed by the Arizona Principal if he or she chooses to obtain all available medical treatment while the reason for his or her incapacity remains unclear.

(8) Guidance For Increasing My Lifespan. Statement E allows the Arizona Principal to specify that all life-prolonging treatments be done if it is what is needed to extend his or her life. Statements that follow this one should not be initialed.

3rd Article Additional Statements I'd want to see implemented here.

(9) Further Statements. This section has two statements that need to be checked off. By knowing whether or not further health care authorizations, refusals, or directions should be included, Arizona doctors examining this document will be better informed. Statement A should be used if more instructions are not provided by the Arizona Principal. To provide additional Arizona Principal health care instructions as an attachment, pick the statement B option (and make sure the concerned attachment is present by the time this document is executed by the Arizona Principal). Verification of a signature.

(10) The Signature of the Arizona Principal. Even though this act must be conducted by the Arizona Principal, two Witnesses or a Notary Public must witness the signing of the Arizona Principal on this document.

(11) Date of Arizona Declarant's Signature

(12) Printed Proxy name. If the Arizona Principal does not have the authority to sign this document but has given a Proxy the authority to do so, this Proxy must be named. An Arizona Principal's Signature Proxy can't additionally serve as a Witness to this document's signature. When asked, the Proxy must print his or her name to identify himself or herself as such.

(13) Proxy Signature. The Principal's Proxy in Arizona must sign his or her name right below the signature supplied by the Principal.

(14). The signature date of the proxy.


(15) Printed Witness Name. It is only if the witness is not a Health Care Agent of the Principal in any manner, shape, and form that he or she may play this position. The witness must also not be a blood relation, marital relation, or connected by adoption to the Arizona Principal to play this role. Witnesses may see the signature of the Arizona Principal (or Proxy) if these conditions are satisfied. The Witness should print his or her name at the beginning of the signature field supplied to attest that this signature was submitted with a full understanding of the outcomes.

(16) Signed by the witness. Arizona's Principal's Witness must sign this document to vouch for the fair and legitimate production of the principal's signature.

(17) Date of the signature of the witness. The date of the Witness's signature should be recorded in the calendar.

(18) Testimony of a Witness. Additionally, the postal address of the Principal's Witness in Arizona must be supplied.

Notarial Jurat

(19) Annotation of the signature of the Arizona Declarant. If the signature of the Arizona Principal is to be authenticated by a Notary Public, then the last portion of this directive will be applied.

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Download our free Arizona living will in an instant to create a legally binding document.

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