(1) A living will may, but need not, be in the following form:

Living Will

Declaration made this _____ day of _____, 19 _____ I, __________, willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare:

If at any time I have a terminal condition and if my attending or treating physician and another consulting physician have determined that there is no medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

It is my intention that this declaration be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and to accept the consequences for such refusal.

In the event that I have been determined to be unable to provide express and informed consent regarding the withholding, withdrawal, or continuation of life-prolonging procedures, I wish to designate, as my surrogate to carry out the provisions of this declaration: Name:

Address:

{c1} {c2}Zip Code:__________ Phone:____________________ I understand the full import of this declaration, and I am emotionally and mentally competent to make this declaration. Additional Instructions (optional): _____(Signed)_____ _____Witness_____ _____Address_____ _____Phone_____ _____Witness_____ _____Address_____ _____Phone_____ (2) The principal's failure to designate a surrogate shall not invalidate the living will. History.--s. 4, ch. 92-199. Home Senators Senator List Find Your Legislators District Maps Vote Disclosures Committees Committee List Committee Publications Search Bill Search Tips Statute Search Tips Site Search Tips Session Bills Calendars Journals Appropriations Conferences Reports Executive Appointments Executive Suspensions Redistricting Laws Statutes Constitution Laws of Florida Order - Legistore Media Publications Videos Topics Video Broadcast Schedule About Employment Visit Us Contact Us Page Program Offices President's Office Majority Office Minority Office Secretary's Office Reference Glossary FAQ Help Links Search Tips Publications Rules Handbooks Advisory Opinions Public Records Connect with the Senate Twitter RSS Senate Tracker Login Sign Up Tracker Help Plug-ins Adobe Acrobat Reader WinZip Disclaimer: The information on this system is unverified. The journals or printed bills of the respective chambers should be consulted for official purposes. Privacy Statement|Accessibility Copyright © 2000- 2026 State of Florida.