Create Your Document In Just 3 Easy Steps:
Answer a few simple questions to make your document in minutes
Start now and save your progress, finish on any device
Store securely, share online and make copies
This document has been customized over 25.7K times
Legally binding and enforceable
Complies with relevant laws
Ask a lawyer questions about your document
LIVING WILL DIRECTIVE
Declaration made this _____ day of ____________, _____.
I, , willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, and do hereby declare:
My wishes regarding life-prolonging treatment and artificially provided nutrition and hydration to be provided to me if I no longer have decisional capacity, have a terminal condition, have been indicated by checking and initialing the appropriate lines below. By checking and initialing the appropriate lines, I specifically provide the following authorization:
If refuses or is not able to act for me, I designate:
Surrogate Name:
Address:
,
Phone:
Relationship:
as my health care surrogate.
. INSTRUCTIONS. If I do not designate a surrogate, the following are my directions to my attending physician. If I have designated a surrogate, my surrogate shall comply with my wishes as indicated below:
If at any time I should have a terminal condition and my attending and one other physician in their discretion, have determined such condition is incurable and irreversible and will result in death within a relatively short time, and where the application of life-prolonging treatment would serve only to artificially prolong the dying process,
. NUTRITION/HYDRATION. Kentucky law provides that a health care surrogate may authorize the withdrawal or withholding of artificially provided nutrition and hydration in the following circumstances:
(a) When inevitable death is expected, by reasonable medical judgment, within a few days;
(b) When authorized by a patient in an advance directive, and the patient becomes permanently unconscious;
(c) When the provision of artificial nutrition cannot be physically assimilated by the person;
(d) When the burden of the provision of artificial nutrition and hydration itself outweighs its benefits.
Artificially provided nutrition in paragraphs (a), (b), and (c) shall not be withheld or withdrawn if it is needed for comfort or the relief of pain.
Based upon my understanding of Kentucky law,
. SEVERABILITY. If any provision in this document is held to be invalid, such invalidity shall not affect the other provisions which can be given effect without the invalid provision, and to this end the directions in this document are severable.
In the absence of my ability to give directions regarding the use of life-prolonging treatment and artificially provided nutrition and hydration, it is my intention that this directive shall be honored by my attending physician, my family and any surrogate designated pursuant to this directive as the final expression of my legal right to refuse medical or surgical treatment and I accept the consequences of such refusal. I understand the full import of this directive and I am emotionally and mentally competent to make this directive.
Signed this _____ day of __________________, _____.
Grantor Signature:______________________________________
Name:
Address:
,
| Name: |
| Address: |
| , |
| Name: | ________________________________ |
| Address: | ________________________________ |
| ________________________________ |
| ________________________________ |
| Name: |
| Address: |
| , |
| Name: | ________________________________ |
| Address: | ________________________________ |
| ________________________________ |
| ________________________________ |
| _____ | (your Health Care Surrogate) |
| * | You should discuss the document and your wishes with any person you want to designate as a Health Care Surrogate before doing so to assure they agree to act on your behalf. |
All the legal documents you need—customize, share, print & more
Unlimited electronic signatures with RocketSign®
Ask a lawyer questions or have them review your document
Dispute protection on all your contracts with Document Defense®
30-minute phone call with a lawyer about any new issue
Discounts! Incorporate for FREE + hire a lawyer with up to 40% off*
*Free incorporation for new members only and excludes state fees. Lawyer must be part of our nationwide network to receive discount.
It's very simple to document your medical wishes using a free Kentucky Living Will template from Rocket Lawyer:
This route is, in most cases, notably less time-consuming than finding and hiring a traditional law firm. If needed, you may start this Living Will on behalf of your spouse, an elderly parent, or another family member, and then help them sign it once you've drafted it. Please note that for this document to be accepted as legally valid, the principal must be an adult who is mentally competent when they sign. If the principal is already incapacitated and unable to make their own decisions, a court-appointed conservatorship may be required. In this scenario, it is important for you to speak to an attorney .
If you are over 18 years old, you ought to have a Living Will. Even though it is painful to acknowledge, a day could come when you are no longer able to make healthcare decisions on your own. Here are a few typical situations where you may consider it useful to make or update your Living Will:
Whether your Kentucky Living Will has been produced as a result of a change in your health or as part of a long-term plan, notarization and/or witnesses can help to protect your agent if someone challenges their power and authority. Under Kentucky law, a Living Will is not considered valid during pregnancy.
Making a Living Will is generally easy to do, but you or your agent might have legal questions. Locating a legal professional to comment on your document might take longer than you expect if you do it by yourself. An easier approach would be through Rocket Lawyer attorney services. Rocket Lawyer Premium members can ask for advice from an experienced attorney or send other legal questions. As always, you can Live Confidently® knowing that Rocket Lawyer is by your side.
The cost of finding and working with a legal provider to write a Living Will might range anywhere between two hundred and one thousand dollars. Unlike many other Living Will template providers you may discover, Rocket Lawyer offers Premium membership holders up to 40% in savings when hiring a lawyer, so an attorney from our Rocket Lawyer attorney network can review the situation and take action if you ever require support.
Attached alongside each Kentucky Living Will form is a set of next steps to take to finalize the document. You also can engage with the PoA in any of the following ways: editing it, downloading it as a Word or PDF file, and/or signing it. Finally, you should ensure that your agent(s) and care providers get their copy of the final document.
The laws governing Living Wills vary in each state; however, in Kentucky, your Living Will needs to be acknowledged by a notary public or signed by two witnesses. Witnesses to a Living Will must not be your attending physician or anyone responsible for your healthcare costs, nor can they be affiliated with your healthcare facility unless providing notary services. Relatives or other beneficiaries are also restricted. As a general rule, your witnesses will need to be over the age of 18, and none should simultaneously be your healthcare agent.
