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Montana Living Will Declaration Form

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The Montana living will is a declaration that the Declarant/Principal would like to announce to all who may possibly be a part of his/her medical decision making team, understand what their wishes are for their end of life selections for medical care. This provides information with regard to how they would like their physicians to provide end of life choices.

Definition – § 50-9-102

Laws – § 50-9-101 to § 50-9-111 (Montana Rights of the Terminally Ill Act)

Medical Power of Attorney – Creates a relationship with a person and a family member and/or close friend to act on their behalf for health care matters.

How to Write

Step 1 – Declaration of Declarant –

  • Date the declaration at the top of the page in dd/mm/yyyy format

Step 2 – Declarant –

  • Enter the Declarant’s name

Step 3 – Review the statement paragraphs – If the Declarant is in agreement:

  • Enter the Declarant’s Signature
  • Date the signature in mm/dd/yyyy format
  • Enter Declarant’s  City, County and State of Residence
  • Declarant’s Date of Birth in mm/dd/yyyy format
  • Enter Declarant’s Social Security Number

Step 4 – Witnesses – This document will require two (2) witnesses. The witnesses must read the statement and enter:

  • Date of witness signatures in dd/mm/yyyy format
  • Each respective witness’ signature
  • Each witness’ complete address

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