Illinois Living Will Act DeclarationIllinois Living Will Act Declaration
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Illinois Living Will Act
(Illinois Compiled Statutes, 755 ILCS 35/1 et seq.

DECLARATION
This declaration is made this

day of

(month, year).

I,
being of sound mind, willfully and
voluntarily make known my desires that my moment of death shall not be artifically postponed.
If at any time I should have an incurable and irreversible injury, disease, or illness judged to be a terminal
condition by my attending physician who has personally examined me and has determined that my death is
imminent except for death delaying procedures, I direct that such procedures which would only prolong the
dying process be withheld or withdrawn, and that I be permitted to die naturally with only the administration of
medication, sustenance, or the performance of any medical procedure deemed necessary by my attending
physician to provide me with comfort care.
In the absence of my ability to give directions regarding the use of such death delaying procedures, it is
my intention that this declaration shall