Oklahoma Living Will Form

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The Oklahoma living will is a legal document that allows the Declarant/Principal to provide instructions in writing regarding how they wish to have their end of life treatment honored by their medical team and family. A provision for a health care proxy is also available should the Declarant have this preference. This document will require the signatures of two unrelated witnesses. If at any point the Declarant does not understand any part of this document, they may wish to consult with a qualified attorney.

Laws – § 63-3101.4

Advance Directive – Combines the living will and medical power of attorney.

Medical Power of Attorney – Elect a surrogate to enable a trusted person to be your health care representative in the chance of incapacitation.

How to Write

Step 1 – Living Will – This will address the desires of the Declarant/Principal and their end of life choices for what treatment they would like at the end of their life.

  • The Declarant/Principal, must read the information in this section and initial only one of the options available

Step 2 – Persistent Unconsciousness – This section will address the desires of the Declarant in the event they are in a coma or vegetative state.

  • The Declarant/Principal must read the statement in this section
  • Initial only one of the selections available

Step 3 – End of Life Decisions due to Illness or Injury- This section will address end of life decisions while involving serious injury that cannot be cured or bring the Declarant back to an acceptable quality of life.

  • The Declarant/Principal must read the information in this section
  • Initial only one of the available selections
  • (If there special instructions available in section 4, initial the line preceding this statement)

Step 4 – Special Instructions –

  • (a) describe other conditions in which you would want life-sustaining treatment or artificially administered nutrition and hydration provided, withheld, or withdrawn,
  • (b) give more specific instructions about your wishes concerning life-sustaining treatment or artificially administered nutrition and hydration if you have a terminal condition, are persistently unconscious, or have an end-stage condition
  • OR
  • (c) do both of these by entering your desired information in the lines provided – if more space is required, add a continued sheet and attach to the document – Be certain to provide your initials at the end on the form

Step 5 – Appointment of Health Care Proxy – This will address the appointment of two people with whom you trust to make health care decisions for you just as if you were present to do it on your own.

  • Name of Proxy Number One
  • Name of Proxy Number Two in the event the first proxy becomes unable or unwilling to serve

Step 6 – Anatomical Gifts – Should you decide that providing anatomical gifts would be something you would like to do, you may make this statement within this document.

  • Select any or all of what you would choose to have your gifts used for by initialing the lines preceding the selections
  • You may also elect to donate your entire body or you may choose to donate any or all of your organs or parts by simply initialing your selections

Step 7 – The Declarant/Principal must read the remainder of the document. Once the final section has been read complete the following:

  • Date the document in dd/mm/yyyy format
  • Enter the Declarant’s Signature
  • City of Residence
  • County, Oklahoma
  • Date of birth (Optional)

Step 8 – Witnesses – Read the following statement and provide the necessary information:

  • This advance directive was signed in my presence

Witness 1 – 

  • Witness’ Signature
  • Oklahoma Residence

Witness 2 – 

  • Witness’ Signature
  • Oklahoma Residence

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