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Louisiana Living Will Declaration Form

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The Louisiana living will declaration is

Definition – §1151.1(4)

Laws§ 1151.2

Registry List – Use the alphabetical list to register your living will after it has been completed.

Medical Power of Attorney – Designation given by the patient to allow someone else to be able to enforce health-related wishes in the principal’s best interest.

How to Write

Step 1 – Establishment of Declarant/Principal – Enter the information as follows:

  • Date the top of the document in dd/mm/yyyy format
  • Enter the full legal name of the declarant/principal

Step 2 – Declarant/Principal End of Life Selections – The Declarant must review the next section in the document.

  • Once reviewed, select by initialing the line preceding your selected manner of the end of life treatment.
  • Read the remainder of the document and enter the Declarant’s
  • signature
  • city
  • parish
  • state of residence

Step 3 – Witnesses – This document will require the signatures of two witnesses – Read the sentence for the witnesses.

  • If the witnesses agree, enter signatures respectively

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