Will form

I, __________________________, being of sound mind and body, do not wish to be kept alive indefinitely by artificial means.

Under no circumstances should my fate be put in the hands of xxxxhead politicians who couldn't pass ninth-grade biology if their lives depended
on it or lawyers/doctors interested in simply running up the bills.

If a reasonable amount of time passes and I fail to ask for at least one of the following:

______a Scotch

______a VB

______a steak

______Crayfish or Prawns

______the remote control

______a bowl of French vanilla ice cream

______the sports page

______Chocolate

______Sex

it should be presumed that I won't ever get better.

When such a determination is reached, I hereby instruct my appointed person and attending physicians to pull the plug, reel
in the tubes and call it a day.


Signature: ___________________________