STATE OF ARIZONA
LIVING WILL (End of Life Care)
Instructions and Form
Information about me: (I am called the “Principal”)
My Date of Birth:
My decisions about End of Life Care:
A. Comfort Care Only: If I have a terminal condition I do not want my life to be prolonged, and I do not want
life-sustaining treatment, beyond comfort care, that would serve only to artificially delay the moment of my
death. (NOTE: “Comfort care” means treatment in an attempt to protect and enhance the quality of life
without artificially prolonging life.)
B. Specific Limitations on Medical Treatments I Want: (NOTE: Initial or mark one or more choices, talk to
your doctor about your choices.) If I have a terminal condition, or am in an irreversible coma or a persistent
vegetative state that my doctors reasonably believe to be irreversible or incurable, I do want the medical
treatment necessary to provide care that would keep me comfortable, but I do not want the following:
1.) Cardiopulmonary resuscitation, for example, the use of drugs, electric shock, and artificial
2.) Artificially administered food and fluids.
3.) To be taken to a hospital if it is at all avoidable.
C. Pregnancy: Regardless of any other directions I have given in this Living Will, if I am known to be pregnant
I do not want life-sustaining treatment withheld or withdrawn if it is possible that the embryo/fetus will
develop to the point of live birth with the continued application of life-sustaining treatment.
D. Treatment Until My Medical Condition is Reasonably