Colorado Living Will Template
This Living Will is created in accordance with Colorado state laws regarding advance medical directives. It allows you to express your wishes regarding medical treatment in the event that you become unable to communicate your decisions.
Personal Information
- Name: ____________________________
- Date of Birth: ______________________
- Address: ___________________________
- City, State, Zip: ___________________
Designation of Healthcare Agent
If you wish to designate a healthcare agent to make medical decisions on your behalf, please provide the following information:
- Agent Name: ________________________
- Agent Phone Number: _______________
- Agent Address: ______________________
Living Will Declaration
I, ____________________________, being of sound mind, willfully and voluntarily make this declaration to express my wishes regarding medical treatment. If I am diagnosed with a terminal condition or am in a persistent vegetative state, I direct that:
- Life-sustaining treatment be withheld or withdrawn.
- I wish to receive comfort care, including pain relief.
- Other specific wishes: ______________________________.
Signature
By signing below, I confirm that I am at least 18 years old and that this Living Will reflects my wishes regarding medical treatment.
Signature: ___________________________
Date: _______________________________
Witnesses
This Living Will must be witnessed by two individuals who are not related to you and who will not benefit from your estate.
- Witness 1 Name: ____________________
- Witness 1 Signature: _______________
- Date: ______________________________
- Witness 2 Name: ____________________
- Witness 2 Signature: _______________
- Date: ______________________________
This document is effective immediately upon signing and remains in effect until revoked. Please keep a copy for your records and provide copies to your healthcare agent and family members.