Directive to Physicians Step 1 of 2 50% This document is also referred to as a "living will." It will instruct physicians and hospitals in the event you are diagnosed with a terminal illness or condition and your death is imminent. This document allows you to appoint an agent to make those decisions if you are not able, however, appointing an agent is optiona. If you would like to discuss this further, please contact us directly.Name* First Last Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Do you have a terminal condition? Yes Doctor's Name* First Last Practice Name* Phone*Who can make your medical life/death decisions?* First Last Formal Signing Ceramony?Would you like to sign your papers at the Law Offices of Robert D. Wilson, P.C., with notaries and witnesses provided? To schedule your signing ceramony, please call the office M-F 9:00-5:00 to arrange a time to come in. PLEASE BRING YOUR VALID STATE IDENTIFICATION CARD, DRIVERS LICENSE or PASSPORT.YesNo Please Review Your Information Double check all entered information below. If everything is correct, click next to continue. If something is incorrect, please scroll to the bottom of this page and click "previous" to go back and make corrections. {all_fields}Directive to Physicians Δ Need Help? Schedule an Appointment with an Attorney by calling 214-637-8866.