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Medical Power of Attorney Template: Healthcare Decisions

Create a comprehensive medical power of attorney document to authorize healthcare decisions on your behalf. Customize your healthcare proxy with our easy-to-use template.

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Parties

Grant of Authority

Effective Date

Durability

Agent's Duties

Revocation

HIPAA Waiver

Governing Law

Signatures

Principal's Signature

Agent's Signature

Preview

MEDICAL POWER OF ATTORNEY

Parties

Principal: [Full Name], residing at [Address], hereinafter referred to as the Principal.

Agent/Attorney-in-Fact: [Full Name], residing at [Address], hereinafter referred to as the Agent.

Grant of Authority

I hereby grant my Agent full power and authority to make healthcare decisions on my behalf.

  • Consent to or refuse medical treatment
  • Employ or discharge medical personnel
  • Access medical records and information
  • Make end-of-life decisions

Effective Date

This Medical Power of Attorney shall become effective immediately upon execution.

Durability

This Medical Power of Attorney shall remain in effect even if I become incapacitated or unable to make decisions for myself.

Agent's Duties

  • Follow my known wishes and preferences
  • Act in my best interests
  • Keep appropriate records of decisions made

Revocation

I may revoke this Medical Power of Attorney at any time by delivering a written, signed notice to my Agent and to my healthcare providers.

HIPAA Waiver

I authorize the release of my medical information to my Agent as necessary to carry out the powers granted in this document.

Governing Law

This Medical Power of Attorney is governed by the laws of [State].

Signatures and Acknowledgment

Principal's Signature: _________________________ Date: [Date]

Printed Name: ________________________________

Agent's Signature: _________________________ Date: [Date]

Printed Name: ________________________________

(Notarization or Witness Requirements Here)

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Frequently Asked Questions

Find answers to common questions about our templates.

What types of power of attorney documents can I create?

You can create various power of attorney documents including limited power of attorney, general power of attorney, durable power of attorney, and other power of attorney variations. All templates are customizable and designed to be legally sound.

Do I need a lawyer for power of attorney documents?

Power of attorney documents grant significant legal authority to another person. While our templates provide a good starting point, we strongly recommend consulting with an attorney, especially for complex situations or when granting broad authority. A lawyer can help ensure the document meets your specific needs and complies with your state's requirements.

What is the difference between limited and general power of attorney?

A limited power of attorney grants authority for specific acts or transactions only, while a general power of attorney grants broad authority to act on your behalf in various matters. Limited power of attorney is typically used for specific purposes like selling a vehicle or signing documents for a real estate transaction.

Do power of attorney documents need to be notarized?

Notarization requirements vary by state and the type of power of attorney. Many states require notarization for power of attorney documents to be valid. We recommend checking your state's specific requirements and having the document notarized to ensure it is properly executed and recognized.

Can I revoke a power of attorney?

Yes, you can revoke a power of attorney at any time by delivering a written, signed notice to the agent and, if necessary, to relevant third parties. Some states may require specific revocation procedures, so we recommend consulting with a lawyer to ensure proper revocation according to your state's requirements.

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Medical Power of Attorney Template: Healthcare Decisions