ONTARIO LIVING WILL
This document is a Living Will, also known as a "Power of Attorney for
Personal Care" in Ontario. The Power of Attorney for personal care must
appoint a proxy (known as the "attorney for personal care") and may
contain an instruction directive.
Under the Substitute Decisions Act of Ontario, the person making the
power of attorney for personal care and the person appointed to be the proxy
must both be at least 16 years old.
A person may not act as proxy if they provide, for pay, health care,
or residential, social, training, or support services to the person making the
living will (unless the person is a spouse, partner, or relative).
The power of attorney for personal care must be witnessed by two people,
and signed by them. The following people may not act as witnesses:
the proxy, the spouse or partner of the patient or proxy,
a child of the patient, and anyone who is less than 18 years old.
POWER OF ATTORNEY FOR PERSONAL CARE
(Made in accordance with the Substitute Decisions Act, 1992)
I, Mr. John Peter Smith, of 123 Main Street, Toronto, Ontario
M1P 3X9, Canada, revoke any previous power of attorney for personal
care and appoint the following person to be my attorney for
personal care in accordance with the Substitute Decisions Act, 1992:
Address: 123 Main Street, Toronto, Ontario, M1P 3X9, Canada
Home phone number: 416-555-0401
Work phone number: 905-555-3484
Cell phone number: 416-555-3873
If the person I have appointed cannot or will not be my attorney because
of refusal, resignation, death, mental incapacity, or removal by the Court,
I substitute the following person to be my attorney for personal care in the
same manner and subject to the same authority as the person he or she is replacing:
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Your Living Will and Power of Attorney for Health Care are custom-made based
on the answers you provide.