New Living 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 politicians who couldn't pass ninth-grade biology if their lives depended on it.

If a reasonable amount of time passes and I fail to sit up and ask for

(please initial all that apply)

_________ a martini,

_________ a margarita,

_________ a beer,

_________ a steak,

_________ the remote control,

_________ a bowl of ice cream,

_________ a rum & coke,

_________ sex,

_________ Wine

_________chocolate

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.

Under no circumstances shall the members of the Legislature enact a special law to keep me on life-support machinery. It is my wish that these boneheads mind their own ###### business, and pay attention instead to the future of the millions who aren't in a permanent coma.

Signature:___________________________

Date: ___________________________

Witness: __________________________