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OTHER NAMES Oregon Advance Directive Oregon Advance Healthcare Directive Oregon Medical Directive Oregon Advance Medical Directive Oregon Advance Health Care Directive

What is an Oregon Living Will?

An Oregon Living Will is a legal document that lays out your preferences related to health care, such as your refusal or acceptance of medical treatment, in addition to the (optional) appointment of a trusted agent or decision maker. 
 
The person making a Living Will is known as the "principal," and the person or entity gaining permission to carry out the principal's wishes is called the "agent." Suited for residents of Oregon, this free Living Will can be used in Clackamas County, Multnomah County, Washington County, and in every other part of the state. Each Oregon Living Will form from Rocket Lawyer can be personalized for your specific situation. This official legal document will provide verification of your decisions to healthcare institutions, and it will confirm that your agent has the authority to act in your interest.

When to use an Oregon Living Will:

  • You want to specify your wishes so that it is more likely they will be carried out.
  • You are facing the possibility of surgery or a hospitalization.
  • You have declining health.
  • You have been diagnosed with a terminal condition.

Sample Oregon Living Will

The terms in your document will update based on the information you provide

This document has been customized over 21.3K times
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ADVANCE DIRECTIVE

 

(You do not have to fill out and sign this form.)

 

PART A: IMPORTANT INFORMATION ABOUT THIS ADVANCE DIRECTIVE

 

This is an important legal document. It can control critical decisions about your health care. Before signing, consider these important facts:

 

FACTS ABOUT PART B (APPOINTING A HEALTH CARE REPRESENTATIVE). You have the right to name a person to direct your health care when you cannot do so. This person is called your "health care representative". You can do this by using Part B of this form. Your representative must accept on Part E of this form.

 

You can write in this document any restrictions you want on how your representative will make decisions for you. Your representative must follow your desires as stated in this document or otherwise made known. If your desires are unknown, your representative must try to act in your best interest. Your representative can resign at any time.

 

FACTS ABOUT PART C (GIVING HEALTH CARE INSTRUCTIONS). You also have the right to give instructions for health care providers to follow if you become unable to direct your care. You can do this by using Part C of the form.

 

FACTS ABOUT COMPLETING THIS FORM. This form is valid only if you sign it voluntarily and when you are of sound mind. If you do not want an advance directive, you do not have to sign this form.

 

Unless you have limited the duration of this advance directive, it will not expire. If you have set an expiration date, and you become unable to direct your health care before that date this advance directive will not expire until you are able to make those decisions again.

 

You may revoke this document at any time. To do so, notify your representative and your health care provider of the revocation.

 

Despite this document, you have the right to decide your own health care as long as you are able to do so.

 

If there is anything in this document that you do not understand, ask a lawyer to explain it to you.

 

You may sign Part B, Part C, or both Parts. You may cross out words that don't express your wishes or add words that better express your wishes. Witnesses must sign Part D.

 

 

Principal Name:

Address:

,

Date of Birth:

 

Unless revoked or suspended, this Advance Directive will continue for (initial one):

 

_____ My entire life

 

_____ Other period:

 

 

PART B: APPOINTMENT OF HEALTH CARE REPRESENTATIVE

 

I appoint , as my health care representative. My representative's address is , , , and telephone number is .

 

I appoint , as my alternate health care representative. My alternate's address is , , , and telephone number is .

 

I authorize my representative (or alternate) to direct my health care when I can't do so.

 

Note: You may not appoint your doctor, an employee of your doctor, or an owner, operator or employee of your health care facility, unless that person is related to you by blood, marriage or adoption or that person was appointed before your admission into the health care facility.

 

. LIMITS. Special conditions or instructions:

 

INITIAL IF THIS APPLIES:

 

_____ I have executed a Health Care Instruction or Directive to Physicians. My representative is to honor it.

 

. LIFE SUPPORT. "Life Support" refers to any medical means for maintaining life, including procedures, devices and medications. If you refuse life support, you will still get routine measures to keep you clean and comfortable.

 

INITIAL IF THIS APPLIES:

 

_____ My representative may decide about life support for me. (If you don't initial this space, then your representative may not decide about life support.)

 

. TUBE FEEDING. One sort of life support is food and water supplied artificially by medical device, known as tube feeding.

 

INITIAL IF THIS APPLIES:

 

_____ My representative may decide about tube feeding for me. (If you don't initial this space, then your representative may not decide about tube feeding.)

 

 

SIGN HERE TO APPOINT A HEALTH CARE REPRESENTATIVE:

 

 

Signature:___________________________________ Date: ____________

 

 

 

PART C: HEALTH CARE INSTRUCTIONS

 

NOTE: In filling out these instructions, keep the following in mind:

 

* The term "as my physician recommends" means that you want your physician to try life support if your physician believes it could be helpful and then discontinue it if it is not helping you health condition or symptoms.

* "Life support" and "tube feeding" are defined in Part B above.

* If you refuse tube feeding, you should understand that malnutrition, dehydration and death will probably result.

* You will get care for your comfort and cleanliness, no matter what choices you make.

* You may either give specific instructions by filling out Items 1 to 4 below, or you may use the general instruction provided by Item 5.

 

Here are my desires about my health care if my doctor and another knowledgeable doctor confirm that I am in a medical condition described below:

 

. CLOSE TO DEATH. If I am close to death and life support would only postpone the moment of my death:

 

A. INITIAL ONE:

 

_____ I want to receive tube feeding.

 

_____ I want tube feeding only as my physician recommends.

 

_____ I do not want tube feeding.

 

B. INITIAL ONE:

 

_____ I want any other life support that may apply.

 

_____ I want life support only as my physician recommends.

 

_____ I want no life support.

 

 

. PERMANENTLY UNCONSCIOUS. If I am unconscious and it is very unlikely that I will ever become conscious again:

 

A. INITIAL ONE:

 

_____ I want to receive tube feeding.

 

_____ I want tube feeding only as my physician recommends.

 

_____ I do not want tube feeding.

 

B. INITIAL ONE:

 

_____ I want any other life support that may apply.

 

_____ I want life support only as my physician recommends.

 

_____ I want no life support.

 

 

. ADVANCED PROGRESSIVE ILLNESS. If I have a progressive illness that will be fatal and is in an advanced stage, and I am consistently and permanently unable to communicate by any means, swallow food and water safely, care for myself and recognize my family and other people, and it is very unlikely that my condition will substantially improve:

 

A. INITIAL ONE:

 

_____ I want to receive tube feeding.

 

_____ I want tube feeding only as my physician recommends.

 

_____ I do not want tube feeding.

 

B. INITIAL ONE:

 

_____ I want any other life support that may apply.

 

_____ I want life support only as my physician recommends.

 

_____ I want no life support.

 

 

. EXTRAORDINARY SUFFERING. If life support would not help my medical condition and would make me suffer permanent and severe pain:

 

A. INITIAL ONE:

 

_____ I want to receive tube feeding.

 

_____ I want tube feeding only as my physician recommends.

 

_____ I do not want tube feeding.

 

B. INITIAL ONE:

 

_____ I want any other life support that may apply.

 

_____ I want life support only as my physician recommends.

 

_____ I want no life support.

 

 

. GENERAL INSTRUCTION.

 

INITIAL IF THIS APPLIES:

 

_____ I do not want my life to be prolonged by life support. I also do not want tube feeding as life support. I want my doctors to allow me to die naturally if my doctor and another knowledgeable doctor confirm I am in any of the medical conditions listed in Items 1 to 4 above.

 

 

. ADDITIONAL CONDITIONS OR INSTRUCTIONS.

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 the continued application of life support, it is my preference that this document be given effect at that point. If life support 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 desire that no anatomical gifts be made from my body.Notwithstanding the other provisions of this document, if I have been determined to be dead according to law, I direct my attending physician to maintain my organs on artificial support systems only for the period of time required to maintain the viability of and to remove the organs and/or tissues which are to be donated. I hereby make an anatomical gift to take effect upon my death. I give I do not consent to an autopsy.I consent to an autopsy if one is requested.My health care representative may give consent to or refuse an autopsy.

 

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, thus the directions in this document are severable.

 

 

. OTHER DOCUMENTS. A "Health Care Power of Attorney" is any document you may have signed to appoint a representative to make health care decisions for you.

 

INITIAL ONE:

 

_____ I have previously signed a Health Care Power of Attorney. I want it to remain in effect unless I appointed a health care representative after signing the Health Care Power of Attorney.

 

_____ I have a Health Care Power of Attorney, and I revoke it.

 

_____ I do not have a Health Care Power of Attorney.

 

 

SIGN HERE TO GIVE INSTRUCTIONS:

 

 

Signature:___________________________________ Date: ____________

 

 

 

PART D: DECLARATION OF WITNESSES

 

We declare that the person signing this advance directive:

(A) Is personally known to us or has provided proof of identity;

(B) Signed or acknowledged that person's signature on this advance directive in our presence;

(C) Appears to be of sound mind and not under duress, fraud or undue influence;

(D) Has not appointed either of us as health care representative or alternative representative; and

(E) Is not a patient for whom either of us is attending physician.

 

 

Witnessed By:

 

 

Signature of Witness:________________________________________

 

Witness Name:

Date: ___________________________________

 

 

 

Signature of Witness:________________________________________

 

Witness Name:

Date: ___________________________________

 

 

NOTE: One witness must not be a relative (by blood, marriage or adoption) of the person signing this advance directive. That witness must also not be entitled to any portion of the person's estate upon death. That witness must also not own, operate or be employed at a health care facility where the person is a patient or resident.

 

 

PART E: ACCEPTANCE BY HEALTH CARE REPRESENTATIVE

 

I accept this appointment and agree to serve as health care representative. I understand I must act consistently with the desires of the person I represent, as expressed in this advance directive or otherwise made known to me. If I do not know the desires of the person I represent, I have a duty to act in what I believe in good faith to be that person's best interest. I understand that this document allows me to decide about that person's health care only while that person cannot do so. I understand that the person who appointed me may revoke this appointment. If I learn that this document has been suspended or revoked, I will inform the person's health care provider if known to me.

 

 

Signature of

Health Care Representative:________________________________________

 

Representative Name:

Date: ___________________________________

 

 

 

Signature of Alternate

Health Care Representative: ________________________________________

 

Representative Name:

Date: ___________________________________

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Oregon Living Will FAQs

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  • How do I write a Living Will in Oregon?

    It is fast and simple to set forth your medical preferences using a free Oregon Living Will template from Rocket Lawyer:

    1. Make your Living Will - Provide a few simple details, and we will do the rest
    2. Send or share it - Look over your wishes with your healthcare agent(s) or seek legal help
    3. Sign and make it legal - Mandatory or not, notarization/witnesses are recommended

    This method is often going to be notably less time-consuming than hiring and working with a conventional attorney. If needed, you may start this Living Will on behalf of a family member, and then help them sign it when ready. Please note that for this document to be valid, the principal must be mentally competent when they sign. In the event that the principal is already incapacitated and unable to make their own decisions, a conservatorship generally will be required. When dealing with such a scenario, it's best for you to connect with a lawyer .

  • Do I need to make a Living Will?

    Every person over 18 years old ought to have a Living Will in place. While it's unpleasant to acknowledge, a day will likely come when you are not able to make your own healthcare decisions. Typical circumstances in which you may find it useful to make or update your Living Will include:

    • You are managing a terminal illness
    • You plan to be hospitalized for a surgical procedure
    • You are preparing to live in a community care facility
    • You are aging or dealing with ongoing health issue

    Regardless of whether your Oregon Living Will is being prepared as part of a forward-looking plan or created as a result of a change in your health, notarization and witnesses can help to protect your document if its authority is doubted by a third party.

  • Should I hire a lawyer for my Living Will in Oregon?

    Making a Living Will is normally easy to do; however, you could still have legal questions. Seeking out a legal professional to proofread your Oregon Living Will might be time-intensive and fairly costly. A more cost-effective route is through the Rocket Lawyer attorney network. When you become a Premium member, you can get your document reviewed or send specific legal questions. As always, Rocket Lawyer will be by your side.

  • What might I traditionally pay to make a Living Will in Oregon?

    The cost of meeting and hiring a traditional attorney to write a Living Will might add up to anywhere between two hundred and one thousand dollars. Unlike many other Living Will template websites that you may find elsewhere, Rocket Lawyer gives Premium membership holders up to 40% in savings when hiring a lawyer, so an attorney can assess the situation and take action if you ever require support.

  • What needs to happen once I have made an Oregon Living Will?

    Attached to your Oregon Living Will form, you'll find a list of helpful tips on what you should do next. You also may take any or all of the following actions with your PoA: making edits, downloading it, printing it out, and/or signing it. Finally, you should give a copy of the fully signed document to your agent(s), care providers, and other impacted parties.

  • Does a Living Will need to be notarized or witnessed in Oregon?

    The specifications governing Living Wills vary in each state; however, in Oregon, your Living Will must be signed by two witnesses or a notary public. The selected witnesses should not include your attending physician, and at least one should not be related to you (such as a spouse, adopted child, or family member) or any other heir/beneficiary. The owners, operators, and employees of your healthcare facility and/or residential care facility are also prohibited. As a basic principle, witnesses will need to be over 18 years old, and none of them should simultaneously be acting as your healthcare agent.

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