Maine Living Will Template
This Living Will is made in accordance with the laws of the State of Maine, as outlined in Title 18-C, Section 5-804 of the Maine Revised Statutes.
Please fill in the information where indicated and make sure to have this document signed as required.
Living Will Declaration
I, [Your Full Name], of [Your Address], in the County of [Your County], State of Maine, being of sound mind, do hereby declare this to be my Living Will.
In the event that I become unable to communicate my wishes regarding medical treatment due to a terminal condition or an irreversible condition, I direct that my wishes regarding life-sustaining treatment be followed as indicated below:
Statement of Wishes
In the event of my terminal condition, I wish:
- To be kept comfortable and free from pain, using medications as necessary;
- To receive or not receive life-sustaining treatment, as follows:
- [Specify life-sustaining treatments you want or do not want]
- [Additional treatment preferences]
If I am in a persistent vegetative state or suffering from an irreversible condition:
- I do not wish to receive [Type of treatment, e.g., artificial nutrition and hydration] if it only prolongs the dying process;
- I request that my family and medical providers respect these wishes.
Additional Instructions
In making this declaration, I affirm that:
- This document reflects my wishes regarding medical treatment.
- I am aware that I can revoke this Living Will at any time.
Signature
Signed on this [Date]:
[Your Signature]
[Printed Name]
Witnesses:
We, the undersigned witnesses, declare that the declarant appears to be of sound mind and under no duress. We affirm that we are not related by blood or marriage to the declarant and have no financial interest in the declarant's estate.
[Witness 1 Signature] - [Printed Name]
[Witness 2 Signature] - [Printed Name]