Living will form

Always one to be prepared, my parents have had a living will in effect for many years.  My dad just forwarded me his latest copy:

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 nitwit 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:
 
 ______a Glass of Wine,
 
 ______a Margarita,
 
 ______a Cold Beer,
 
 ______anything Chocolate,
 
 ______a pork chop
 
 ______shrimp, lobster, crab legs or fish,
 
 ______the remote control
 
 ______a  bowl of ice cream
 
 ______a culinary magazine of any kind
 
 ______a hot dog, hamburger or bologna sandwich
 
 ______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.  At this point it is time to call the New Orleans Jazz Funeral Band to come do their thing at my funeral, and ask all of my friends to raise their glasses to toast the good times we have had.

Signature:      ___________________________

Date:     ___________________________