[{"id":"47aad51e-1321-4265-adfe-0b5e1d51a5bb","order":1,"text":"LIVING WILL","fontSize":"22","textAlign":"center","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"0"},{"id":"13ddec37-f674-4d84-9725-51b2ca2ec382","order":2,"text":"AND ADVANCE HEALTH CARE DIRECTIVE","fontSize":"16","textAlign":"center","bold":true,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"389d942f-d1ba-49f3-90b5-42e6a3876cee","order":3,"text":"ARTICLE I — DECLARATION","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"20"},{"id":"b1689f73-a8d1-4cbd-8099-69237090ed26","order":4,"text":"I, [Your full legal name], born on [Date of birth] in [Place of birth], currently residing at [Street address], [City], California [ZIP code], being of sound mind and acting voluntarily, willfully and after careful consideration, do hereby make this Living Will and Advance Health Care Directive (the "Directive") to declare my wishes regarding the medical care I receive in the event I become unable to communicate my decisions due to terminal illness, persistent vegetative state, or end-stage condition.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true},{"id":"957450cc-92e4-4f5d-b329-74335aaad603","order":5,"text":"This Directive is executed under the laws of the State of California and shall be construed in accordance therewith. It is my intention that this Directive be honored by my family, my physicians, and all health care providers as the final expression of my legal right to refuse or accept medical treatment, and I accept the consequences of such refusal or acceptance.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"c55d0716-d124-4921-a809-fde28f396fb7","order":6,"text":"ARTICLE II — DEFINITIONS","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"10"},{"id":"0c3f6de2-ba5f-4184-b466-cb85776fc9b5","order":7,"text":"Terminal condition means an incurable and irreversible condition caused by injury, disease, or illness that, within reasonable medical judgment, will result in death within a relatively short period of time, regardless of the application of life-sustaining procedures.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a5ac1e98-a06d-4d07-8789-56e50e07e8c9","order":8,"text":"Persistent vegetative state means a condition of profound non-responsiveness in the cerebral and cognitive functions of the brain, in which the patient has no awareness of self or environment and shows no behavioral responses to external stimuli, as determined by current accepted medical standards.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"0b91eb5c-8f09-4701-a8c8-70de8205992d","order":9,"text":"End-stage condition means an advanced, progressive, and irreversible condition caused by injury, disease, or illness that has resulted in severe and permanent deterioration indicated by incompetency and complete physical dependency, and for which, to a reasonable degree of medical certainty, treatment of the irreversible condition would be medically ineffective.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"9df022a4-2065-4e24-898e-d683b4cbf2c4","order":10,"text":"Life-sustaining treatment means any medical procedure, treatment, intervention, or other measure that, when administered, would serve only to artificially prolong the dying process, including but not limited to cardiopulmonary resuscitation (CPR), mechanical ventilation, dialysis, antibiotics, and blood transfusions.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"c2e67c01-6270-4d20-a673-6b502ccd2c30","order":11,"text":"ARTICLE III — DESIGNATION OF HEALTH CARE AGENT","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"5cfc8424-7227-4dea-87ec-08a7237d685e","order":12,"text":"I hereby designate and appoint the following individual as my Health Care Agent, with full authority to make any and all health care decisions on my behalf in the event I am unable to make or communicate such decisions myself:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"70e3f873-365c-491e-a296-7e5559603b52","order":13,"text":"Name: [Agent full name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"f14b0f87-97d1-4430-ab7b-9f9b2a05de45","order":14,"text":"Relationship: [Relationship to you]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"0f192a60-82c7-4b55-ab0b-21b795c80a71","order":15,"text":"Address: [Street address], [City], California [ZIP]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"b7677d74-b415-4c52-8621-7e53e418a21e","order":16,"text":"Telephone: [Phone number]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"a012a8d3-500e-4f6a-9050-176b53f6edba","order":17,"text":"Email: [Email address]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"0161a665-3613-43be-9956-c06790445b2e","order":18,"text":"My Health Care Agent, [Agent full name], is authorized to:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"df464186-22dd-407e-b514-2540a8b269cd","order":19,"text":"(a) Consent, refuse to consent, or withdraw consent to any medical or surgical procedure, including the administration of medications and the use of life-sustaining treatment;","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"f2592a01-9c66-4902-a2e1-3acf9978c057","order":20,"text":"(b) Authorize my admission to or discharge from any hospital, nursing facility, hospice, or other health care facility;","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"c9a8c7b9-d964-43b1-8c5a-bfa3b1e5dc43","order":21,"text":"(c) Have access to and disclose any of my medical records and information protected under the Health Insurance Portability and Accountability Act (HIPAA) and applicable state law;","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"f6dd6e35-9cf0-441b-aea9-60f1f6dbbec8","order":22,"text":"(d) Employ and discharge health care providers and to authorize any palliative or comfort care measures;","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"359d3c1c-215e-42f4-a974-6cf7243caf63","order":23,"text":"(e) Make decisions regarding the donation of my organs and tissues, the disposition of my remains, and to authorize an autopsy, in accordance with this Directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="}]},{"id":"12b18295-be25-4d68-8eee-fd41606b69c9","order":24,"text":"Alternate Health Care Agent. If my designated Health Care Agent is unable, unwilling, or unavailable to act on my behalf, I hereby designate the following individual as my Alternate Health Care Agent, with the same authority and powers granted herein:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"5","displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="},{"field":"41c19688-64f0-4869-8479-44a54b099e7a","value":"No","type":"remove","operator":"="}]},{"id":"0558ab08-e4db-42f8-a6af-675b61ab0169","order":25,"text":"Name: [Alternate Agent name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="},{"field":"41c19688-64f0-4869-8479-44a54b099e7a","value":"No","type":"remove","operator":"="}]},{"id":"12f4dba1-2e0f-415f-80bc-c89b8e9a5dd0","order":26,"text":"Relationship: [Relationship]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="},{"field":"41c19688-64f0-4869-8479-44a54b099e7a","value":"No","type":"remove","operator":"="}]},{"id":"870f2b9b-101e-497e-8b6f-928970c9869e","order":27,"text":"Address: [Street address], [City], California [ZIP]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="},{"field":"41c19688-64f0-4869-8479-44a54b099e7a","value":"No","type":"remove","operator":"="}]},{"id":"f09e5111-1ef2-4b88-a7f1-7c4c97e92c05","order":28,"text":"Telephone: [Phone]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="},{"field":"41c19688-64f0-4869-8479-44a54b099e7a","value":"No","type":"remove","operator":"="}]},{"id":"e347463b-a4db-4652-a976-10142ce5648a","order":29,"text":"Email: [Email]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"41fc93b7-edd5-4439-8d62-efb5303f659f","value":"No","type":"remove","operator":"="},{"field":"41c19688-64f0-4869-8479-44a54b099e7a","value":"No","type":"remove","operator":"="}]},{"id":"847ab42e-ef37-4019-a9ed-981643b5109e","order":30,"text":"ARTICLE IV — DIRECTIONS REGARDING LIFE-SUSTAINING TREATMENT","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"10"},{"id":"f1e11ba8-4670-4c00-b6b9-3513649b7c76","order":31,"text":"If, at any time, I am diagnosed in writing by my attending physician and one (1) additional physician as having a terminal condition, persistent vegetative state, or end-stage condition, and the application of life-sustaining treatment would serve only to artificially prolong the process of dying, I declare:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true},{"id":"e960ca14-d3e0-4af6-9c45-1fadabbf49ea","order":32,"text":"Section 4.1 — Life-Sustaining Treatment. I direct that life-sustaining treatment be withheld or withdrawn, so that I may be permitted to die naturally with only the administration of medication and the performance of any medical procedure deemed necessary to provide comfort care or to alleviate pain.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true},{"id":"2ae81fc7-6b0c-48ba-83af-8b5672e77a6a","order":33,"text":"Section 4.2 — Artificial Nutrition and Hydration. I direct that artificial nutrition and hydration be withheld or withdrawn, recognizing that this is a separate decision from other forms of life-sustaining treatment.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true},{"id":"59565ad7-872a-44bc-944c-0f1e5d08a19c","order":34,"text":"Section 4.3 — Pain Management and Comfort Care. I direct that I be given medication and treatment to relieve pain and suffering, even if such treatment may shorten my life. It is my express wish that I be kept reasonably free from pain.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true},{"id":"84418f15-c3d1-4bc5-be5e-75f2ef94da5d","order":35,"text":"Section 4.4 — Pregnancy Provision. If I am pregnant, this Directive shall have no force or effect during the course of my pregnancy.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"23908be3-deeb-49ec-b361-c02692bd3a34","order":36,"text":"ARTICLE V — ANATOMICAL GIFTS","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"10"},{"id":"e1774d82-9a02-4c14-bdd4-d0e6e98a2de2","order":37,"text":"Pursuant to the Uniform Anatomical Gift Act, as adopted by the State of California, I hereby make an anatomical gift, to be effective upon my death.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"2ce96661-21e4-4eae-91e6-5b894905b664","order":38,"text":"I authorize the donation of any needed organs, tissues, or other body parts for any purpose authorized by law (transplantation, therapy, research, and education).","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"73c02730-aa9c-4936-b740-27f731000c1d","value":"I do not wish to make an anatomical gift","type":"remove","operator":"="}]},{"id":"7b4b754a-3f47-4fc1-a70c-b3a82ebc3ef4","order":39,"text":"ARTICLE VI — ADDITIONAL INSTRUCTIONS","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"10"},{"id":"5f5ce9ca-b12a-4409-8614-3b6ca892e946","order":40,"text":"In addition to the foregoing, I express the following personal instructions and wishes:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7030a3a0-1f94-4f87-aeff-214573fe902b","order":41,"text":"[Your additional instructions (or leave blank)]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"fontWeight":400},{"id":"a1e2f43d-d75a-4ce4-8700-987ec6907ab7","order":42,"text":"ARTICLE VII — GENERAL PROVISIONS","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"10"},{"id":"0d3c86c3-d1e6-4844-a4d3-c4ad88370465","order":43,"text":"Section 7.1 — Revocation. I reserve the right to revoke this Directive at any time by any of the means permitted by applicable law, including by signed written instrument, oral declaration, or by physical destruction of this document with the intent to revoke.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"19f8e54e-8262-4371-9963-275a5f19e33f","order":44,"text":"Section 7.2 — Effect. This Directive shall be presumed to be valid and shall remain in full force and effect until revoked. The invalidity of any provision shall not affect the validity or enforceability of any other provision.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"23afcd8d-4ca0-426f-8c31-208f479ecbc3","order":45,"text":"Section 7.3 — Liability. No physician, health care provider, or other person acting under their direction or in good faith reliance upon this Directive shall be subject to civil liability, criminal prosecution, or professional disciplinary action for following the directions herein.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"3c774664-0abd-4b8a-bfb1-9da316619c3a","order":46,"text":"Section 7.4 — Reciprocity. This Directive is intended to be valid in any jurisdiction in which it is presented. The fact that this Directive may not comply with the technical formalities of a particular state shall not affect its validity to the extent that it expresses my wishes.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"25","cflou":false,"active":true},{"id":"243ecc88-cd75-4db8-afb6-044392a9cc9e","order":47,"text":"SIGNATURE OF DECLARANT","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"15"},{"id":"a1202e21-dc33-4571-b933-d2385a55994c","order":48,"text":"I have carefully read this Living Will and Advance Health Care Directive and fully understand its meaning and consequences. I am at least eighteen (18) years of age, of sound mind, and acting of my own free will, without duress, fraud, or undue influence.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true},{"id":"d50e19e8-4faf-4449-8ae4-23add35f44ac","order":49,"text":"Executed this [Date of signing], at [City].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"35aa902d-2f2e-41a9-9607-434e5213a89d","order":50,"text":"_______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"659cc10b-cd81-49b3-8f68-c2f62cb25887","order":51,"text":"[Your full legal name], Declarant","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"9fb57f5e-1ea0-4131-abd5-45c1e01911d1","order":52,"text":"STATEMENT OF WITNESSES","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true},{"id":"987fdc45-a09a-43ea-8f19-591577e17542","order":53,"text":"We, the undersigned witnesses, being each at least eighteen (18) years of age, declare under penalty of perjury that the Declarant, [Declarant full name], signed this Living Will and Advance Health Care Directive in our presence, that the Declarant appeared to be of sound mind and under no duress, fraud, or undue influence, and that we are not related to the Declarant by blood, marriage, or adoption, are not entitled to any portion of the Declarant's estate upon his or her death, and are not directly financially responsible for the Declarant's health care.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"628ca49b-229d-4c25-978d-0ecfc45785ab","order":54,"text":"FIRST WITNESS","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"6854ea21-4b82-4b76-8e62-ef1d75965337","order":55,"text":"_______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"9a43d38d-5907-4997-a7b9-2144fdf50b3f","order":56,"text":"Name: [First witness name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"b08ad047-ed4c-4bd0-948e-3436a6e343fd","order":57,"text":"Address: [Street], [City], California [ZIP]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"24d7bdf1-daa4-4706-a7c6-6999afafce4d","order":58,"text":"SECOND WITNESS","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"31b8fbff-c070-45c0-aef6-44960b48e4b4","order":59,"text":"_______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"960e7917-d142-4b6e-b4a0-560ef7ded332","order":60,"text":"Name: [Second witness name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"3d8c7189-bb29-4607-9a08-6f8f4f466e2b","order":61,"text":"Address: [Street], [City], California [ZIP]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"1fd4a40f-6ee5-4136-908e-0c6351f8a6f4","order":62,"text":"NOTARY ACKNOWLEDGMENT","fontSize":"15","textAlign":"left","bold":true,"underline":true,"marginBottom":"15","cflou":false,"active":true,"marginTop":"20"},{"id":"27667f7f-70db-496e-a233-8c47d45bbb61","order":63,"text":"State of ______________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"4acc30e2-9574-419c-a1e8-c171bbfbc350","order":64,"text":"County of ______________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"15","cflou":false,"active":true},{"id":"c0cfb0e0-2f6f-4b8b-844d-b376bab4893e","order":65,"text":"On this day, [Date of signing], before me, the undersigned Notary Public, personally appeared [Declarant name], who is personally known to me or who provided satisfactory proof of identification, and who, being duly sworn, acknowledged executing the foregoing Living Will and Advance Health Care Directive as his or her free and voluntary act, for the purposes therein set forth, and further acknowledged that [First witness name] and [Second witness name], also personally known to me or who provided satisfactory proof of identification, signed the same in his or her presence as witnesses.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"03cd78c4-5af3-4b7a-a9b8-b65cf4e6d195","order":66,"text":"IN WITNESS WHEREOF, I hereunto set my hand and official seal.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"25","cflou":false,"active":true},{"id":"bf0c3234-e894-40e0-bc26-1802628e4370","order":67,"text":"_______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"f6a2e6dd-a77a-4fd1-a047-d20eb2f34017","order":68,"text":"Notary Public","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"3c768c2d-a487-468f-8a5b-4b400fa09717","order":69,"text":"My commission expires: ______________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"06bb2f15-0161-4d45-bda0-461ec569cab5","order":70,"text":"[NOTARY SEAL]","fontSize":"13","textAlign":"center","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true,"fontWeight":300},{"id":"08c88f87-3288-4b16-9474-dec967ce99b9","order":71,"text":"IMPORTANT NOTICE TO THE DECLARANT","fontSize":"14","textAlign":"center","bold":true,"underline":false,"marginBottom":"15","cflou":false,"active":true,"marginTop":"20"},{"id":"5c2ee5e0-3c03-49a5-a9e8-0493c9c64929","order":72,"text":"This document is a legally significant instrument. Before signing, you should fully understand the consequences of executing it. The exact legal requirements for a valid Living Will and Advance Health Care Directive vary from state to state. To ensure that this Directive is enforceable in your state, you are strongly encouraged to consult with a licensed attorney admitted to practice in your jurisdiction. You should also discuss its terms with your physician and provide copies to your designated Health Care Agent, your immediate family, and your primary care physician.","fontSize":"12","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"fontWeight":300},{"id":"4d0045da-f056-48ae-a4f7-34ba05ed0ebd","order":9999,"text":"Document prepared on captain.legal — This document is provided as a template and does not constitute legal advice.","fontSize":"10","textAlign":"center","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true,"isFooter":true}]