Louisiana Living Will Form

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The Louisiana Living Will is the formal document used to specify your desires surrounding life-ending decisions. When an individual enters a comatose state and a living will (or medical POA) has not been executed, loved ones can feel conflicted with how things should be handled, especially if there are differing opinions between the fellow family members. With the implementation of this instrument, the individual can declare that they wish not to prolong their life should the doctor consider their condition irreversible. To complete the form, users will have to provide the date of execution, their name, whether or not they wish to receive artificial nutrition & hydration, and their signature which is to be performed in front of two (2) witnesses.

(Donate Life Louisiana is an online registry where residents of the state can sign up to be organ donors.)

Other Versions (5)

Franciscan Missionaries of Our Lady Health System Version

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LSU Health Version

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Ochsner Health System Version

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Peoples Health Version

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Spanish/Español Version

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Additional Resources

Related Forms (6)

Advance Directive (Medical POA & Living Will)

Download: Adobe PDF

 

 

 


Advance Directive for Mental Health Treatment

Download: Adobe PDF
Laws: RS 28:221 et sec.

 

 


Advance Directive Wallet Cards

Download: Adobe PDF

 

 

 


Durable (Financial) Power of Attorney

Download: Adobe PDF, MS Word (.docx)

 

 

 


HIPAA Authorization Form (specific to Blue Cross, Blue Shield, & HMO)

Download: Adobe PDF

 

 

 


Physician Orders for Scope of Treatment (LaPOST) Form

Download: Adobe PDF
Spanish Version: Adobe PDF
Laws: RS 40:1155.1 et seq.