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An agent or attorney-in-fact who represents the principal on their behalf in matters related to healthcare when they are not in a position mentally or physically to take the decisions for themselves is a Medical Power of Attorney. A medical power of attorney can be appointed by filling the medical power of attorney form. The powers that the attorney-in-fact holds can also be restricted and any wishes related to the medical treatment that the principal might or might not want to take can also be mentioned. A person of complete trust and faith must only be chosen as the medical power of attorney as their decisions are considered as equal as of the principal’s and they hold complete authority to deny or terminate any medical treatment, surgery, medication, life support, etc., if they feel the need to do so.

A medical power of attorney form generally includes the full and legal name of the principal and that of the agent, their addresses, details of a successor agent (if required), description of the powers that the medical power of attorney holds, special instructions or restrictions that the principal might want to add, declaration by the agent, signatures by all the parties involved, etc.
Below you would find a list of Medical Power of Attorney Forms for each states in the United States of America.





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Hawaii Medical Power of Attorney Form - PDF Template

Hawaii Health-Care Decisions Act, Hawaii Rev. Stat. §§327E-1 to 327E-16 permits you to execute Hawaii Medical Power of Attorney and/or Preparing Will To Live Durable Power Of Attorney. Execution of such legal document permits the agent to take health care decisions on your behalf especially when you are incapacitated to do so. This document remains …

Connecticut Health Care Power of Attorney Form - PDF Template

Download and sue this form in the State of Connecticut to grant someone else to make Health and Medical related decisions on your behalf. Connecticut-Health-Care-Power-of-Attorney-Form Text Version of the Form ———————– Page 1———————– POWER OF ATTORNEY FOR HEALTH CARE DECISIONS Notice : The powers granted by this document are broad and sweeping. They are defined in Connecticut …


Colorado Health Care Power of Attorney Form - PDF Template

The Health care power of attorney form is a very important form when the need arises someone else to take medical decisions on behalf of another person. This is a Colorado health care power of attorney form, it is only applicable in state of Colorado, United States of America. To use this form download it …

California Medical Power of Attorney Form - PDF Template

The California Medical Power of Attorney form is used when one cannot make medical decisions by themselves owing to reasons beyond the control. This form provided here is just a reference document and you may need to edit or modify the contents of this document so that they meet your requirements. Although this form is …

Arizona Medical Power of Attorney Form - PDF Template

This is a medical power of attorney form that is applicable in the state of Arizona. The medical power of attorney is a legal document that is to be signed by an adult who is known as “principal”. According to the medical power of attorney the principal can entrust another person on his behalf to …

Arkansas Medical Power of Attorney Form - PDF Template

The Arkansas medical power of attorney form use of this form is to assign someone else on your behalf to make decisions related to your personal medical state and other medical related decisions. This form is in accordance to the power of attorney law in Arkansas. A medical power of attorney is a form in …

Texas Declaration for Mental Health Treatment Form - PDF Template

Download and use this form if you want to make advance decisions about your mental health treatment. Text Version of this Form ———————– Page 1———————– Notice To Person Making a Declaration For Mental Health Treatment Chapter 137, Title 6, Civil Practice and Remedies Code This is an important legal document. It creates a declaration for mental …

Texas Do Not Resucitate (OOH-DNR) Form - PDF Template

Texas Do Not Resucitate (OOH-DNR) Texas Do Not Resucitate (OOH-DNR) This document becomes effective immediately on the date of execution for health care professionals acting in out-of-hospital settings. It remains in effect until the person is pronounced dead by authorized medical or legal authority or the document is revoked. Comfort care will be given as …

Texas Medical Power of Attorney Form - PDF Template

Advance Directives Act §166.163, Health and Safety Code permit you to issue Texas Medical Power of Attorney to appoint an agent to make health care decision for you when you are declared incompetent to do so by a physician in writing. Please read the form and instructions carefully before proceeding. You, your nominated agent, and …

Alabama Medical Power of Attorney Form - PDF Template

Download and Use this form to assign someone else on your behalf to take Medical decisions in your Interest. This form will only be applicable in the State of Alabama. Alabama Medical Power of Attorney – DOC Alabama Medical Power of Attorney – PDF Text Version of the Form ———————– Page 1———————– STATE OF ALABAMA ) ) …

Florida Medical Power of Attorney Form - PDF Template

The following is a medical power of attorney form, this form is only applicable in the state of Florida in the United States of America. This form is used when one cannot make medical decisions by themselves owing to reasons beyond the control. This form provided here is just a reference document and you may …

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