This Statutory Living Will form allows you to express your wishes and desires if it is determined that your death will occur whether or not life-sustaining procedures are utilized and where the application of life-sustaining procedures would serve only to artificially prolong the dying process. It is a declaration that such procedures be withheld or withdrawn, and that you be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide you with comfortable care. This form contains an optional provision for appointing a surrogate to make health care decisions for you according to your stated wishes if you are unable to do so yourself. A health care surrogate is the equivalent of an agent under a health care power of attorney. The surrogate/agent may consent to, or withdraw consent for, any medical procedure, treatment or intervention.