Free Medical Power of Attorney Forms

Medical POA

Also called a healthcare proxy, ‘medical power of attorney’ is a legal instrument that a patient uses to delegate the making of critical healthcare decisions on his behalf. This power is invoked when the patient concerned is unable to make the said decisions on his own.

What is the Medical Power of Attorney?

Some sicknesses may take too much of a toll on the patients concerned. These include Alzheimer’s, Parkinson’s disease, and vegetative state. Obviously, it is impossible for a patient suffering from these illnesses to make radical and far-reaching decisions. It is only by delegating the same to a competent person that sound decisions may be realized.

This power gives a patient the leeway to delegate the said responsibility. It makes the patient appoint someone who is mentally stable to carry on at the point of his incapacitation onwards. Such a person has to be trustworthy enough to act within the best interest of the patient concerned.

Other names of Medical Power of Attorney

This power goes by other names. These names are outlined hereunder:

  • Medical Power of Attorney Directive
  • Durable Power of Attorney for Health Care
  • Health Care Power of Attorney
  • Advance Health Care Directive
  • Advance Directive
  • Health Care Proxy

Associated Terminology

Some terms and languages are used to convey or exercise this power. These are the key terms in the field:

a.) Incapacity

Incapacity refers to the physical and mental inability to carry out some affairs. When such happens, the person affected may not always be able to carry out critical decisions or express their wishes succinctly as the need may so determine or dictate.

b.) Pre-arrangement

Pre-arrangement is the fact that the ‘medical power of attorney’ may be drafted well in advance before the incapacitation arises. It, however, ‘waits’ until the incapacitation arises for it to become effective. Pre-arrangement exists to prevent any loopholes or gray areas whenever the incapacitation eventually arises.

c.) Attorney-in-fact

An attorney-in-fact is the person whom a patient appoints to make the crucial medical decisions on his behalf. He goes by the alternate names of ‘agent,’ or ‘representative.’ This person is bound to follow the laid down regulations and to act with the best interest of the patient at heart.

Basic contents of a Medical POA

The ‘medical power of attorney’ of necessity has to contain the following issues:

  • Name and physical address of the primary “attorney-in-fact.”
  • Name and address of the optional “attorney-in-fact.”
  • Health Insurance Portability and Accountability Act of 1996 release
  • Stipulated powers and responsibilities
  • Further guidance to the “attorney-in-fact.”
  • Advanced healthcare directive or living will
  • Optional consent to donate your organs or tissues
  • Signatures of the principal and the witnesses
  • Appropriate notarization

Free Medical POA Forms (by State)

Choose the required form & State from the list below to create the required form by using a step by step wizard or download the form for the required state.

Sample Medical POA Form

Sample Medical POA Form

When do you need a medical POA?

Extremely Elderly

You will need this legal power when you are extremely elderly. As people approach their sunset years, they lose the power to make sound and rational decisions on their own. To be able to ‘make’ similar decisions as they age, the intervention of a person of sound mind badly comes in.

Risky Careers

Some careers like aviation, mining, chemical engineering, military, and space exploration are too risky. Those who pursue them are often at the risk of dying at any time. Such a person needs to delegate the powers to a person who is in a less risky career to help out.

Terminally Ill

If you are terminally ill, i.e. have a sickness which is incurable, you yet again have to invoke the assistance of a healthy person. This person has to be able to make critical and far-reaching decisions that are in your best interest at a time when you no longer have that ability yourself.

Mental Instability

The same case above applies to mental instability. A mentally unstable person cannot definitely make far-reaching medical decisions on his own. That is why the person has to seek the assistance of another person to do the same for him.

Difference between a ‘Living Will’ and ‘Medical POA.’

A ‘living will’ lets the person concerned expressly state his preferences or wished for the end-of-life medical care in case they happen to be too incapacitated to make such decisions on their own later on. It has no power after the death of the patient.

The ‘medical power of attorney,’ however, delegates the role to a third party. Power of attorney is someone of a sound mind, preferably related to the patient, and is trustworthy enough to act within the best wishes of the patient concerned.

Legal Advice and Considerations

As you leverage this power, there are several issues you have to factor. Below are the common issues you have to take care of:

State Laws

The laws that govern this power varies significantly from one state to another. You have to be familiar with the laws that exist in your state as you do not want to ruffle feathers with the authorities. You may have to bring in an attorney to help with the compliance with these laws.


Though largely unnecessary, it is also advisable that you get the form notarized by a notary public. Notarization is to make the form legally binding and widely acceptable. In this way, you will also get to dispel any disputes or ambiguities which may arise in the course of its implementation.


As we have already hinted, lawyers are not necessary for the entire process of drafting and implementing the document. However, you will find their intervention useful and necessary when filing and executing the form as the language you use has to be clearly understood.


You have to clearly spell out the grounds which the form has to be invoked, and the attorney-in-fact has to come in. These grounds have to be legitimate and stipulated for the avoidance of any ambiguities in the course of execution.


Lastly, you have to know and follow the procedures involved in the letter. The processes are just as good as the intent and purposes of the document itself. Skipping a step may also render the entire document null and void to the extent of missing out on that very step.

Related Posts