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Download medical power of attorney form in PDF format.
Using the Medical Power of Attorney Form
A medical power of attorney form may also be known as health care power of attorney form. Through this power of attorney you can authorize someone to take decisions with regard to your health care when you are unable to communicate the decisions yourself.
In instances like mental health treatment, the patient is unlikely to have the ability to communicate or understand health care decisions and through the medical power of attorney form, a close relative or a doctor can be empowered to take the necessary decisions on behalf of the individual undergoing treatment. In some circumstances, patients may wish to remain on life support. The legal provision in this respect (G.S.90-321 article 90 chapter 321) is clear that in the absence of a medical power of attorney form, the health care provider can decide to take the patient off life support when the condition warrants.
For a medical power of attorney form to be effective, there are some basic requirements. In the first place, your physicians should provide a written decision that you are no more capable of making your own health care decisions. The power of attorney should be witnessed by two individuals and also notarized by a notary public. Notice also that in some states, the law may require the witnesses to be qualified witnesses. Qualified witnesses are adults, not related to the principal, competent, and not being a business partner or physician’s relative. Once this document is drawn up and executed, copies should be sent to members of your family, your doctor/s, your attorney and any other person concerned with your health and well being. The original document is your own property and should ideally be kept in a place that is easily accessible to the members of your family.
The medical power of attorney form is often executed in anticipation of possible state of body and mind where the principal may not be capable of taking his/her health care decisions. The individual who is executing the power of attorney will also be required to sign a disclosure stating that he/she has completely read and understood the content of the document. The state law may also require that the witness signing the document verifies and confirms that the executor did in fact read and understood the content. It is important that the individual who is authorized as the attorney/agent should be trustworthy and capable of enforcing your wishes. When the spouse is appointed as the agent, the power will be revoked automatically if the two people get divorced.
A medical power of attorney form can be revoked at any time when the executor notifies the agent and the health care provider in writing of his/her intention to revoke the authority. To achieve this, a revocation of power of attorney form is usually executed.