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Other Names: Louisiana Living Will Louisiana Advance Healthcare Directive Louisiana Medical Directive Louisiana Advance Medical Directive Louisiana Advance Health Care Directive
Louisiana Advance Directive document preview

What is a Louisiana Advance Directive?

A Louisiana Advance Directive (or "Declaration Concerning Life-Sustaining Procedures") is a legal document that sets forth your wishes in relation to medical care, such as your refusal of or request for specific medical treatments, and/or appointment of a trusted healthcare agent. 
 
The person making an Advance Directive is called the "principal," and the people or organizations receiving authority to carry out the principal's wishes are known as "agents." Designed for Louisiana residents, this Advance Directive is made for use in Jefferson Parish County, Orleans Parish County, East Baton Rouge Parish County, and in every other county or municipality throughout the state. Each Louisiana Advance Directive from Rocket Lawyer can be tailored for your unique situation. With this legal document on hand, your healthcare providers will have a point of reference for your preferences, and your representative will be able to offer proof that they have the authority to act in your interest.

When to use a Louisiana Advance Directive:

  • You're making sure your loved ones aren't put in the position of making important end-of-life healthcare decisions for you.
  • You're about to draft a complete estate plan, and want to make sure life-sustaining treatments are covered.

Sample Louisiana Advance Directive

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LIVING WILL

and

HEALTH CARE POWER OF ATTORNEY

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

(LIVING WILL)

(HEALTH CARE PROXY)

(LIVING WILL AND HEALTH CARE PROXY)

DECLARATION

and

HEALTH CARE PROXY

LIVING WILL

and

MEDICAL DURABLE POWER OF ATTORNEY

DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE-SUPPORT SYSTEMS

HEALTH CARE INSTRUCTIONS

DOCUMENT CONCERNING THE APPOINTMENT OF A HEALTH CARE REPRESENTATIVE FOR HEALTH CARE DECISIONS

OF

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

and

DESIGNATION OF HEALTH CARE SURROGATE

DECLARATION

and

STATUTORY FORM

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

A LIVING WILL

A Directive to Withhold or to Provide Treatment

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

LIVING WILL DECLARATION

and

COMBINED DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND HEALTH CARE REPRESENTATIVE APPOINTMENT

DECLARATION

and

DESIGNATION OF ADVOCATE FOR HEALTH CARE DECISIONS

HEALTH CARE POWER OF ATTORNEY

DECLARATION OF A DESIRE FOR A NATURAL DEATH

and

HEALTH CARE POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

ADVANCE HEALTH-CARE DIRECTIVE

INSTRUCTIONS FOR HEALTH CARE

and

HEALTH CARE POWER OF ATTORNEY

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION

HEALTH CARE PROXY OF

ADVANCE DIRECTIVE OF

LIVING WILL DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

ADVANCE CARE PLAN

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

ADVANCE DIRECTIVE

and

MEDICAL POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION TO PHYSICIANS

(WISCONSIN LIVING WILL)

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

AND

MEDICAL POWER OF ATTORNEY

 

I. LIVING WILLI. ADVANCE DIRECTIVEI. DECLARATIONI. DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE SUPPORT SYSTEMSI. A LIVING WILL - A DIRECTIVE TO WITHHOLD OR TO PROVIDE TREATMENTI. LIVING WILL DECLARATIONI. HEALTH CARE INSTRUCTIONSI. DECLARATION OF A DESIRE FOR A NATURAL DEATHI. HEALTH CARE DIRECTIVEI. DECLARATION TO PHYSICIANS (WISCONSIN LIVING WILL)Declaration made this ______ day of ____________________, _____. I, , willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare:This is an important legal document known as an advance directive. It is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known because of illness or injury. These wishes are usually based on personal values. In particular, you may want to consider what burdens or hardships of treatment you would be willing to accept for a particular amount of benefit obtained if you were seriously ill. You are encouraged to discuss your values and wishes with your family or chosen spokesperson, as well as your physician. Your physician, other health care providers, or medical institution may provide you with various resources to assist you in completing your advance directive. Brief definitions are listed below and may aid you in your discussions and advance planning. Initial the treatment choices that best reflect your personal preferences. Provide a copy of your directive to your physician, usual hospital, and family or spokesperson. Consider a periodic review of this document. By periodic review, you can best assure that the directive reflects your preferences. I, , being of sound mind, willfully and voluntarily make this Declaration for my care to be followed if I become unable to express my desires directly as a consequence of physical or mental incapacity or disability, regardless of whether this is caused by illness, accident, or other injury. This document is intended to direct all persons who are involved with my care including my relatives, physicians or personal representatives which I have appointed, or which hereafter may be appointed by the courts.
even if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be continued to prolong my life as long as possible within the limits of generally accepted health care standards.

__________ (initial) I have a terminal condition

__________ (initial) or I have an irreversible condition

__________ (initial) or I am in a persistent vegetative state

AND if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

 

TO RECEIVE artificially administered nutrition and hydration (food and fluids).NOT TO RECEIVE artificially administered nutrition and hydration (food and fluids) procedures, except as deemed necessary to provide me with comfort care.However, if at any point it is determined that it is not possible that the fetus could develop to the point of live birth with continued application of life-prolonging procedures, it is my preference that this document be given effect at that point. If life-prolonging procedures will be physically harmful or unreasonably painful to me in a manner that cannot be alleviated by medication, I request that my desire for personal physical comfort be given consideration in determining whether this document shall be effective if I am pregnant. I have discussed these decisions with my physician and have also completed a Physician Orders for Scope of Treatment (POST) from that contains directions that may be more specific than, but are compatible with, this Directive. I hereby approve of those orders and incorporate them herein as if fully set forth. I have not completed a Physician Orders for Scope of Treatment (POST) form. If a POST form is later signed by my physician, then this living will shall be deemed modified to be compatible with the terms of the POST form.

 

I designate , who may be reached at , as my Primary Physician.

 

 

 

 

 

 

 

 

including but NOT including . unless I initial the following line:

 

(YOU MUST DATE AND SIGN THIS LIVING WILL AND DESIGNATION

(YOU MUST DATE AND SIGN THIS DESIGNATION

IN THE PRESENCE OF TWO WITNESSES)

I affirm that this Living Will and Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

I affirm that this Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

 

I designate , who may be reached at , as my Primary Physician.

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this living will by . Further, at least one of us is not a spouse or blood relative of .

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this Living Will and Designation by . I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

 

Date: ______________________________

 

Date: ______________________________

The foregoing instrument was acknowledged before me this _____ day of ____________________, ______ by , who is personally known to me or who has produced ________________________________ as identification.

Before me, a Notary Public (or justice of the peace) in and for said county, personally appeared the above named , ________________________________, and ________________________________, who acknowledged that they did sign the foregoing instrument, and that the same is their free act and deed. In testimony whereof, I have hereunto subscribed my name at ________________________________, this _____ day of ____________________, ______.

This instrument was acknowledged before me on this _____ day of ____________________, ______ by .

On this _____ day of ____________________, ______, before me personally appeared , to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed same as his/her free act and deed.

On this _____ day of ____________________, ______, before me, ________________________________, personally appeared , known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same as for the purposes therein contained.

In witness whereof, I hereunto set my hand and official seal.

 

_________________________________

My commission expires _____________

You should sign this document in the presence of a notary public. You should sign this document in the presence of two witnesses who then sign the document in your presence and in each other's presence. You should sign this document in the presence of a notary public and two witnesses who then sign the document in your presence and in each other's presence.

(your Agent)

You should discuss the document and your wishes with any person you want to designate as an Agent before doing so to assure they agree to act on your behalf.

 

Louisiana Advance Directive FAQs

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  • How do I make an Advance Directive in Louisiana?

    It is fast and simple to outline your medical wishes using a free Louisiana Advance Directive template from Rocket Lawyer:

    1. Make your Advance Directive - Answer a few questions, and we will do the rest
    2. Send or share - Review the document with your healthcare agent(s) or seek legal help
    3. Sign it - Required or not, notarization and witnesses are a best practice

    This solution, in many cases, would be much less time-consuming than hiring and working with a traditional law firm. If needed, you can fill out an Advance Directive on behalf of your spouse or another family member, and then help that person sign when ready. Please keep in mind that for this document to be valid, the principal must be mentally competent at the time of signing. In the event that the principal has already been declared legally incompetent, a court-appointed conservatorship generally will be necessary. When managing such a situation, it would be best to speak to an attorney .

  • Who should have an Advance Directive?

    If you are over 18 years old, you ought to have an Advance Healthcare Directive (both a Healthcare Power of Attorney and a Living Will) in place. Even though it's unpleasant to acknowledge, there will likely come a time when you are no longer able to make your own healthcare decisions. Typical situations in which you may consider it helpful to make or update your Advance Directive include:

    • You've been diagnosed with a terminal condition
    • You are facing the possibility of medical procedure or period of hospitalization
    • You have plans to live in a community care facility
    • You are getting older or dealing with ongoing health issues

    Regardless of whether this Louisiana Advance Directive is being made as a result of a recent change in your health or as part of a forward-looking plan, witnesses and notarization are highly recommended as a best practice for protecting your document if a third party disputes its authority.

  • Do I need to hire an attorney for my Advance Directive in Louisiana?

    Making an Advance Directive is usually easy to do; however, you may still need legal advice. Seeking out a legal professional to proofread your document can take a lot of time if you try to do it alone. Another approach worth consideration is to request help from the On Call network. Rocket Lawyer members can request guidance from an attorney with relevant experience or get answers to additional legal questions. As always, you can Live Confidently® knowing that Rocket Lawyer is by your side.

  • How much does it usually cost to make an Advance Directive in Louisiana?

    The cost of hiring a lawyer to produce an Advance Directive could be anywhere between two hundred and one thousand dollars, depending on where you are. Unlike other Advance Directive template providers that you may come across elsewhere, Rocket Lawyer offers Premium members up to a 40% discount when hiring a lawyer, so an attorney from our network can review the situation and take action if you ever need support.

  • Would I have to do anything else once I have made my Louisiana Advance Directive?

    As a Rocket Lawyer member, you will be able to make edits, save it as a PDF document or Word file, or print it out. In order to finalize your Advance Directive, it will need to be signed. Be sure that your agent(s) and care providers get a copy of your fully executed document. Your Advance Directive can be filed with the Lousiana End of Life Registry , if desired.

  • Does an Advance Directive need to be notarized or witnessed in Louisiana?

    The requirements will vary in each state; however, in Louisiana, your Advance Directive requires the signatures of two witnesses. As a general standard, witnesses must be at least 18 years old, and no witness should also be named as your healthcare agent.

Louisiana Advance Directive document preview

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