MyLivingWill™ - Sample Document

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:

Name: Jane Smith

Relationship: wife

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:

Page 1 of 5

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Your Living Will and Power of Attorney for Health Care are custom-made based on the answers you provide.

 

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