New Living Will Form

I, _(your name here)___________, 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 pinhead 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 (please check at least one, else, what good is this for, forchrissakes!?!?):

______ a cold beer

______ a glass of wine

______ a Bloody Mary

______ a Margarita

______ a Scotch and soda

______ a Martini

______ a Vodka and Tonic

______ a Bourbon on the rocks

______ a Steak

______ Lobster or crab legs

______ The remote control

______ a Bowl of ice cream

______ The sports page

______ a new rifle

______ 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: ___________________________

Date: ___________________________