Kentucky Living Will Directive And Health Care Form Page 5

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5.
On page three, you will sign and date the form. Sign and date the form in the
presence of two witnesses over the age of 18 OR in the presence of a Notary
Public.
The following people CANNOT be a witness to or serve as a notary public:
a)
A blood relative of yours;
b)
A person who is going to inherit your property under Kentucky law;
c)
An employee of a health care facility in which you are a patient (unless the
employee serves as a notary public);
d)
Your attending physician; or
e)
Any person directly financially responsible for your health care.
6.
Once you have filled out the Living Will and either signed it in the presence of witnesses
or in the presence of a notary public, give a copy to your personal physician and any
contacts you have listed in the Living Will. A copy of any Living Will should be put in
your medical records. Remember, you are responsible for telling your hospital or nursing
home that you have a Living Will. Do not send your Living Will to the Office of the
Attorney General.

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