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South Carolina Living Will Declaration Form

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The South Carolina living will form is a legal document that allows a Declarant/Principal to voluntarily and willingly make their own desires known, that there should be no life-sustaining procedures that should be used to prolong the death of the Declarant if in fact, their condition is terminal or if it happens that they are in a state of permanent unconsciousness. If at any time the declarant’s condition is certified to be a terminal by two physicians who have thoroughly examined the declarant one of which is the attending physician of the declarant, and should it be the first and second of opinon physicians agree that my death could occur within a reasonably short period of time without the use of life-sustaining procedures then the declarant’s end of life desires should be honored. This document may be revoked at any time as long as the declarant is competent to do so.

Laws – Title 44, Chapter 66 (Adult Health Care Consent Act)

Medical Power of Attorney – Use to create a relationship with someone else to represent your best interests in association with health care needs if the patient cannot make them.

How to Write

Step 1 – Establishment of Declarant –

  • Enter the full legal name of the declarant/principal
  • Enter the declarant’s social security number
  • Enter the city of the declarant’s residence
  • Enter the county of residence in the state of South Carolina
  • Enter the date of the execution of  the document in dd/mm/yyyy format

Step 2 – The Declarant must read the paragraphs stating their decisions for end of life treatmet

Step 3 –Instructions Concerning Artificial Nutrition and Hydration – In the box provided, there will be selections that the declarant  must make with regard to their options for their end of life treatments.

  • The declarant must read each section, select their preferred option and initial the best choice for themselves personally, in each section within the box provided
  • Declarant must read the remaining information

Step 4 – Selection of Agent – Unlike most Agents, you may choose an agent that may not only assist with honoring your end of life wishes, but the agent, if you so desire, may also revoke this document if they feel that your desires are not being met appropriately.

  • In this section, name the agent you would like to have the power to revoke your document
  • Enter the agent’s address
  • Enter the agent’s telephone number
  • AND
  • Name the agent with the power to enforce your document
  • Enter the agent’s address
  • Enter the agent’s telephone number
  • In the same section, the declarant must read the procedures for revocation. Once the information has been read and understood
  • Enter the Declarant’s signature at the end of the section describing the revocation procedures

Step 5 – Witnesses – To complete this document your witnesses must enter their names into the first section

  • Begin by placing the name of the state of South Carolina into the first line
  • In the second line, place the name of the county in which the document is being executed inside of the state
  • The witnesses then must carefully review the information in the section , once the witnesses have read and feel they are in agreement they must enter their signatures at the end of the document

Step 6 – Notarization – Once the Notary Public has witnessed all signatures, the notary will proceed to complete the document as required by law, authenticating the document and signatures by affixing the state seal to the document.


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