Living Will

                                LIVING WILL OF
        
                           __________________________
             
             If I should have an incurable or irreversible condition that will
        cause my death within a relatively short time, it is my desire that my
        life not be prolonged by administration of life-sustaining procedures. 
        
             If my condition is terminal and I am unable to participate in
        decisions regarding my medical treatment, I direct my attending
        physician to withhold or withdraw procedures/treatments that merely
        prolong the dying process and are not necessary to my comfort or to
        alleviate pain. 
        
             I [__]do [__]do not desire that nutrition or hydration (food and
        water) be provided by gastric tube or intravenously if necessary. 
        
             Notwithstanding the other provisions of this declaration, if I
        have donated an organ under this declaration or by another method, and
        if I am in a hospital when a do not resuscitate order is to be
        implemented for me, I do not want the do not resuscitate order to take
        effect until the donated organ can be evaluated to determine if the
        organ is suitable for donation.
        
             In the event of my death, I donate the following part(s) of my
        body for the purposes identified in AS 13.50.020:
        
                  Tissue:
                  ___________ Eyes
                  ___________ Bone and connective tissue
                  ___________ Skin
                  ___________ Heart
                  ___________ Other
                  Limitations: ____________________________________________
        
                  Organ:
                  ___________ Heart
                  ___________ Kidney(s)
                  ___________ Liver
                  ___________ Lung(s)
                  ___________ Pancreas
        
                  Other: __________________________________________________
        
        
             I have executed on this same date a Medical Directive, the terms
        of which should be followed by my agent, my family and health
        providers.
        
             SIGNED at Fairbanks, Alaska this__________ day of _________
        
                                                                  
                                      
        
             The declarant is known to me and voluntarily signed or
        voluntarily directed another to sign this document in my presence. 
        
        Witness:                                                    
        Address:                                                     
        
        Witness:                                                    
        Address:                                                    
        
        STATE OF ALASKA          )
                                 ) ss:
        FOURTH JUDICIAL DISTRICT )
        
             THIS IS TO ACKNOWLEDGE that on this      day of ____________,
        before me, the undersigned Notary Public in and for Alaska, appeared,
        ____________, known to me to be the individual named in the foregoing
        Living Will, and acknowledged that the information contained therein
        is true and that she executed the same freely and voluntarily for the
        purpose stated therein.
        
             GIVEN under my hand and official seal the day and year last above
        written.
        
                                 _______________________________ 
                                 Notary Public in and for Alaska.
                                 My Commission Expires:_________