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ADVANCE DIRECTIVE FOR A NATURAL DEATH ('LIVING WILL')

(Rev. 07-08 -2022) STATE OF NORTH CAROLINA ADVANCE DIRECTIVE FOR A NATURAL DEATH ( LIVING WILL ) COUNTY OF _____ NOTE: YOU SHOULD USE THIS DOCUMENT TO GIVE YOUR health care PROVIDERS INSTRUCTIONS TO WITHHOLD OR WITHDRAW LIFE-PROLONGING MEASURES IN CERTAIN SITUATIONS. THERE IS NO LEGAL REQUIREMENT THAT ANYONE EXECUTE A LIVING WILL. My Desire for a NATURAL DEATH I, _____, being of sound mind, desire that, as specified below, my life not be prolonged by life-prolonging measures: 1. When My Directives Apply My directions about prolonging my life shall apply IF my attending physician determines that I lack capacity to make or communicate health care decisions and: NOTE: YOU MAY INITIAL ANY OR ALL OF THESE CHOICES.

advance directive for a natural death (“living will’) county of _____ note: you should use this document to give your health care providers instructions to withhold or withdraw life-prolonging measures in certain situations. there is no legal requirement that anyone execute a living will. my desire for a natural death

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