Fillable Living Will Template for Arkansas State Access Your Form

Fillable Living Will Template for Arkansas State

The Arkansas Living Will form is a legal document allowing individuals to outline their preferences for medical treatment in the event they cannot make decisions for themselves. It serves as a guide for family members and healthcare providers, ensuring that one's healthcare wishes are known and respected. Individuals interested in preparing for the future can take the first step by filling out the form by clicking the button below.

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Outline

The Arkansas Living Will form empowers individuals to articulate their preferences for medical treatment in scenarios where they might not be able to communicate their decisions personally. This document is paramount in planning for the future, serving as a trusted guide for healthcare providers and loved ones during challenging times. It addresses a variety of scenarios, including the refusal or acceptance of specific medical treatments and end-of-life care options. By filling out this form, people can ensure their health care choices are respected, offering peace of mind to themselves and their families. The concept behind this document is not only about making critical medical decisions in advance but also about providing clear instructions that help avoid confusion and conflict among family members. In essence, the Arkansas Living Will form is a proactive approach to managing one's health care preferences, reflecting thoughtful consideration and personal values.

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Arkansas Living Will Template

This Living Will is designed to comply with the Arkansas Rights of the Terminally Ill or Permanently Unconscious Act. It allows you to express your wishes regarding medical treatment in the event that you become unable to communicate those wishes yourself.

Part 1: Personal Information

Full Name: ________________________________

Address: ___________________________________

City: ______________________ State: AR Zip: _________

Date of Birth: ______________________________

Social Security Number: _____________________

Part 2: Health Care Instructions

In the event I am diagnosed as terminally ill or permanently unconscious and unable to communicate, I direct that the following preferences for treatment apply:

  • Use all treatments to extend my life for as long as possible, regardless of my condition.
  • Do not use treatments that would only prolong the dying process if I am terminally ill and there is no expectation of recovery.
  • Avoid artificially provided food and water if I am permanently unconscious and there is no reasonable expectation of my recovery.

Part 3: Health Care Proxy

I appoint the following individual as my health care proxy to make medical decisions for me if I am unable to make those decisions myself:

Name: ________________________________

Relationship: ________________________

Phone Number: ________________________

If my primary proxy is unavailable, I appoint the following individual as my alternate proxy:

Name: ________________________________

Relationship: ________________________

Phone Number: ________________________

Part 4: Organ Donation

I do / do not (circle one) wish to donate my organs, tissues, and eyes in the event of my death.

Part 5: Signature

This document represents my wishes regarding medical treatment. I understand the nature and effect of this document. This Living Will is made voluntarily and without any coercion.

Date: ________________________ Signature: ______________________________

Part 6: Witness Statement

We declare that the individual known as ______________________ has signed this Living Will in our presence and appears to be of sound mind and free of duress or undue influence.

Witness 1 Name: ________________________ Signature: ______________________________ Date: ________________________

Witness 2 Name: ________________________ Signature: ______________________________ Date: ________________________

File Details

Fact Number Fact Detail
1 The Arkansas Living Will is legally called the Declaration of a Desire for a Natural Death.
2 It is governed by Arkansas Code § 20-17-202 to § 20-17-217, which outlines the requirements and validity of living wills in the state.
3 This document allows individuals to make decisions about their end-of-life medical treatment in advance.
4 To be valid, the form must be signed by the declarant and either witnessed by two individuals who are not heirs or beneficiaries or notarized.
5 It can be revoked at any time by the declarant through various means, such as a signed and dated written statement, an oral declaration, or by destroying the document intentionally.
6 This document does not take effect unless the individual is diagnosed as being in a terminal condition or in a permanent vegetative state, where they are unable to make decisions for themselves.
7 Arkansas law requires that the living will be either typed or printed to ensure clarity and prevent misunderstandings.
8 The form allows individuals to refuse or request life-sustaining treatment and artificially provided nutrition and hydration.
9 A copy of the living will should be provided to the individual's physician, who will make it part of the individual's medical records.

Detailed Instructions for Filling Out Arkansas Living Will

Filling out an Arkansas Living Will form is a thoughtful way to communicate your healthcare wishes if you become unable to express your preferences. This document lets you detail the kinds of medical treatment you would or would not want to receive in various situations. Taking the time to complete this form ensures that your healthcare providers and loved ones understand your wishes, providing peace of mind for everyone involved. Below are the steps needed to accurately fill out the Arkansas Living Will form.

  1. Begin by downloading the most current version of the Arkansas Living Will form from a reliable source, such as a healthcare provider or legal resource website.
  2. Read through the entire form first to familiarize yourself with the kinds of decisions you'll need to make.
  3. In the section labeled "Personal Information," input your full legal name, date of birth, and address. Ensure this information is accurate to avoid any confusion regarding your identity.
  4. Review the medical treatment options presented in the form. These may include decisions about life-support measures, pain management, and other interventions. Take your time to consider what you would want in various scenarios.
  5. For each treatment option, mark your choice clearly. If the form allows for written preferences, use concise, clear language to describe your wishes.
  6. If the form offers a section for additional instructions, such as organ donation preferences or funeral arrangements, fill this in according to your wishes. Remember, this section is optional but can be valuable for providing complete guidance to your loved ones.
  7. Designate a healthcare proxy or agent by filling in the designated space with the name, relationship, and contact information of the person you trust to make healthcare decisions on your behalf if you're unable to do so. Make sure to discuss this with the person beforehand to confirm their willingness and understanding of your wishes.
  8. Review the form to ensure all information is complete and reflects your wishes accurately. Look for any areas that might create confusion or ambiguity and clarify as needed.
  9. Sign and date the form in the presence of the required witnesses or a notary public, depending on state requirements. This step is crucial for the document to be legally binding.
  10. Make copies of the signed form. Distribute them to your healthcare proxy, family members, and any healthcare providers you regularly visit. Consider keeping a digital copy as well, accessible to your healthcare proxy.

After completing your Arkansas Living Will form, it's essential to revisit it periodically or after significant life events, such as a marriage, divorce, or diagnosis of a serious illness. Updating your living will ensures that it always accurately reflects your current wishes and circumstances.

Your Questions, Answered

What is an Arkansas Living Will?

An Arkansas Living Will is a legal document that lets you outline your healthcare wishes in advance, particularly the types of life-sustaining treatments you would or wouldn't want if you become unable to communicate due to illness or incapacity. This document speaks for you when you can't speak for yourself, ensuring your healthcare preferences are known and considered.

Who can make a Living Will in Arkansas?

Any person who is 18 years of age or older and of sound mind can make a Living Will in Arkansas. This means you must understand the nature and consequences of your decisions at the time of making the document.

Do I need a lawyer to create a Living Will in Arkansas?

No, you do not need a lawyer to create a Living Will in Arkansas. However, consulting with a legal professional can help ensure your Living Will complies with Arkansas law and accurately reflects your healthcare wishes.

How can I revoke or change my Arkansas Living Will?

You can revoke or change your Arkansas Living Will at any time. You can do so by creating a new Living Will that states the previous one is revoked, by physically destroying the original document with the intent to revoke it, or by orally declaring your intention to revoke it in the presence of a witness 18 years of age or older. Remember, communication is key; make sure your healthcare providers and loved ones are aware of any changes.

When does an Arkansas Living Will become effective?

Your Arkansas Living Will becomes effective when your doctor certifies that you are either unable to communicate your healthcare decisions or you are in a terminal condition where making healthcare decisions is beyond your capacity. It is then, and only then, that your Living Will guides your healthcare providers about your treatment preferences.

What should be included in an Arkansas Living Will?

An Arkansas Living Will should include your personal identification details, your specific instructions on the acceptance or refusal of medical treatment, including life-sustaining measures, and your preferences for palliative care. It might also include the nomination of a healthcare proxy, someone you trust to make healthcare decisions on your behalf if you're unable to do so yourself.

Does my Arkansas Living Will expire?

No, your Arkansas Living Will does not automatically expire. It remains in effect unless you revoke it or specify an expiration date within the document itself.

Is an Arkansas Living Will the same as a Do Not Resuscitate (DNR) order?

No, an Arkansas Living Will and a Do Not Resuscitate (DNR) order are not the same. A Living Will is broader and covers more aspects of healthcare decisions, including the use of life-sustaining treatments. A DNR is a specific medical order not to perform CPR if your heart stops or if you stop breathing.

How do I ensure my Arkansas Living Will is followed?

To ensure your Arkansas Living Will is followed, discuss your wishes with your healthcare provider and give them a copy of the document. Also, share it with your healthcare proxy (if you've appointed one) and loved ones so they understand your preferences. Keeping it accessible, such as in a digital registry or with a healthcare directive service, can also help ensure it's followed in an emergency.

Common mistakes

When filling out an Arkansas Living Will form, individuals often aim to ensure their health care preferences are respected if they can no longer communicate their wishes. However, mistakes can be made in the process, leading to confusion or even legal complications. Understanding these common errors can help in creating a clear and effective document.

  1. Not fully understanding the options: Many people rush through the form without fully understanding the implications of their choices. Every checkbox and statement on a Living Will form can carry significant legal weight, determining the extent of life-sustaining treatments you receive or refuse.

  2. Leaving sections blank: It's crucial to complete each section of the form. Skipping parts can lead to ambiguity about your wishes, putting undue stress on your loved ones and medical team to interpret your intentions.

  3. Failing to update the document: It's not uncommon for people's healthcare preferences to change over time. An outdated Living Will might not accurately reflect your current wishes, making it essential to review and update your document regularly.

  4. Not discussing with family or healthcare providers: Merely filling out the form isn't enough. It's important to discuss your decisions with family members and healthcare providers to ensure they understand and respect your wishes. This communication can prevent conflicts and confusion later.

  5. Inadequate signatures: The Arkansas Living Will requires your signature and typically the signatures of witnesses or a notary public. Failure to follow these signing requirements can render the document invalid.

  6. Not making the document accessible: A Living Will is only useful if it's available when needed. Keeping it locked away where no one can access it defeats its purpose. It's advisable to give copies to your healthcare proxy, family members, and primary healthcare provider.

  7. Misunderstanding the role of the health care proxy: Some people confuse the Living Will with a Health Care Power of Attorney. It's important to know that a Living Will outlines your wishes, while a Health Care Power of Attorney designates someone to make decisions on your behalf. Both are important but serve different functions.

Making a Living Will is a significant step in planning for the future. By avoiding these common mistakes, you can ensure your healthcare wishes are understood and respected. Remember, it's okay to seek professional guidance when filling out legal documents like a Living Will. Legal professionals can provide clarity and peace of mind, ensuring your document is both effective and legally sound.

Documents used along the form

Completing a Living Will in Arkansas is a significant step in planning for future healthcare decisions. It allows individuals to express their wishes regarding medical treatment should they become unable to communicate. To ensure comprehensive coverage and clarity in one's healthcare and end-of-life wishes, the Living Will should be accompanied by several other important documents. These additional documents can offer more detailed instructions or cover areas not addressed by the Living Will itself.

  • Durable Power of Attorney for Health Care: This legal document enables an individual to appoint someone they trust to make health care decisions on their behalf, should they become incapacitated. This person, known as a health care agent, can make decisions that align with the patient's wishes and values.
  • Do Not Resuscitate (DNR) Order: A DNR order instructs health care providers not to perform CPR (cardiopulmonary resuscitation) if a person's breathing stops or if the heart stops beating. It is signed by a physician and is based on the individual's health care preferences and medical condition.
  • HIPAA Release Form: The Health Insurance Portability and Accountability Act (HIPAA) keeps a person's health information private. By signing a HIPAA release form, individuals allow specified persons to access their medical records. This can be crucial for health care agents to make informed decisions.
  • Organ and Tissue Donation Form: This allows individuals to specify their wishes regarding organ and tissue donation at the time of death. These forms can ensure that a person's decisions about donation are followed precisely.
  • Living Trust: While not directly related to health care decisions, a living trust is an important estate planning tool. It helps manage a person's assets while they're alive and allows for an easier transfer of assets upon their death, often bypassing the probate process.
  • Last Will and Testament: This document outlines how a person’s assets and property should be distributed after their death. It can also specify guardianship preferences for any minor children. This ensures that their wishes regarding their estate are respected and legally upheld.
  • Incorporating these documents with a Living Will can provide a comprehensive plan for the future, ensuring that an individual's health care and estate preferences are honored. It's always recommended to seek legal advice when preparing these documents to ensure they meet Arkansas's legal requirements and accurately reflect the individual's wishes.

Similar forms

The Arkansas Living Will form is similar to other documents used in estate planning and healthcare decision-making, such as the Healthcare Power of Attorney and the Durable Power of Attorney. Each of these documents serves a unique purpose, but they all focus on ensuring a person's wishes are respected, especially in situations where they cannot communicate their desires themselves.

The first document that the Arkansas Living Will form closely resembles is the Healthcare Power of Attorney. This document allows an individual to appoint someone else, often called a healthcare proxy or agent, to make medical decisions on their behalf if they become unable to do so. The similarity lies in their mutual focus on healthcare decisions. However, while a living will typically outlines specific wishes regarding end-of-life care, a Healthcare Power of Attorney provides broader authority, covering a wide range of medical decisions beyond end-of-life situations.

Another document similar to the Arkansas Living Will form is the Durable Power of Attorney for finances. This document grants an agent the authority to handle financial affairs on behalf of the principal. Although it primarily concerns financial matters, its structure mirrors that of a living will in terms of establishing a durable legal arrangement meant to take effect under specific circumstances, such as incapacity. Both documents ensure that important decisions regarding a person's life and assets are managed according to their preferences when they're unable to oversee these matters themselves.

Dos and Don'ts

Filling out an Arkansas Living Will form is a responsible step to ensure your health care preferences are respected. When completing this document, attention to detail and clarity are paramount. The following lists outline key practices to adopt and avoid during this process:

Do:
  1. Read the instructions carefully before you start filling out the form to make sure you understand each section.
  2. Use clear and specific language when detailing your medical care preferences to prevent any misinterpretation.
  3. Include your full legal name and any other identifying information required to avoid any confusion with another patient.
  4. Discuss your decisions with your healthcare provider to ensure they are feasible and align with medical standards.
  5. Choose a trustworthy person as your health care agent who understands your wishes and is willing to advocate on your behalf.
  6. Review your form with a legal professional if possible, to ensure all legal requirements are met and your document is valid.
  7. Sign and date the form in the presence of the required number of witnesses or a notary public, as mandated by Arkansas law.
  8. Inform close family members, your healthcare provider, and your healthcare agent that you have completed a Living Will and where it is stored.
Don't:
  • Fill out the form in haste or without fully understanding the implications of your decisions.
  • Use vague language that might be open to interpretation when specifying your healthcare directives.
  • Forget to update your Living Will if your health condition or treatment preferences change.
  • Fail to comply with Arkansas-specific requirements for witnesses or notarization, which might invalidate your document.
  • Neglect to give copies of your Living Will to your healthcare agent, family members who need to be aware, and your healthcare provider.
  • Rely solely on verbal instructions to your healthcare agent or family members without documenting your wishes in the Living Will.
  • Overlook the importance of reviewing and, if necessary, revisiting your Living Will periodically, especially after significant life events.
  • Assume your healthcare provider will automatically know your preferences without having a copy of your Living Will on file.

Misconceptions

The Arkansas Living Will form is an important document that allows individuals to set forth their wishes regarding medical treatment and end-of-life care. However, misconceptions about this document are common. Addressing these misconceptions is crucial for ensuring that individuals are fully informed about their rights and options regarding their healthcare. Here are ten common misconceptions about the Arkansas Living Will form:

  • It is only for the elderly: A common misconception is that living wills are only necessary for older adults. However, any competent adult can, and arguably should, have a living will. Unexpected medical situations can occur at any age, and having a living will ensures your wishes are known and respected, regardless of your age.
  • It's complicated to create: Many people believe creating a living will is a complicated and time-consuming process. In reality, the Arkansas Living Will form is straightforward and can be completed without the need for legal assistance, although consulting with a lawyer can provide valuable clarification and peace of mind.
  • A lawyer must draft it: While legal advice can be helpful, it is not a requirement for the creation of a living will in Arkansas. The state provides forms that are designed to be filled out without the need for a lawyer. It's the individual's clarity about their healthcare wishes and the proper witnessing of the document that are most critical.
  • It covers all medical decisions: Another misconception is that a living will covers all possible medical decisions. In reality, a living will typically addresses only those decisions related to life-sustaining treatment when the individual is termina

Key takeaways

The Arkansas Living Will form is a significant document that allows individuals to express their wishes regarding medical treatment in the event they are unable to communicate their decisions. Understanding how to fill out and use this document correctly is crucial for it to be effective and legally recognized. Here are key takeaways to guide you through this process:

  • The form must be completed while the individual is of sound mind to ensure their wishes are clear and accurately represented.
  • Two witnesses or a notary public are required to validate the signature on the living will, establishing its legitimacy.
  • Discuss your preferences and the details of your living will with your family and healthcare provider to avoid any confusion or disputes later on.
  • Select a durable power of attorney for healthcare, a trusted individual who will make healthcare decisions on your behalf if you are unable to do so.
  • The living will does not activate until a physician certifies that you are incapacitated and unable to make medical decisions for yourself.
  • Regularly review and update your living will to reflect any changes in your health condition or personal preferences.
  • Keep the original document in a safe, accessible place, and provide copies to your healthcare agent, family members, and healthcare providers.
  • Be aware that the living will is only applicable within the state of Arkansas; if you spend a significant amount of time in another state, consider creating a separate document that complies with that state’s laws.

Properly filling out and using the Arkansas Living Will form is an act of foresight and consideration, ensuring that your healthcare wishes are known and respected during critical times. Using this guide, individuals can take concrete steps to safeguard their healthcare preferences and provide peace of mind for themselves and their loved ones.

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