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Medical Power of Attorney

Medical Power of Attorney (MPOA) Form

Empower Someone to Make Medical Decisions for You When You Can't.

A Medical Power of Attorney (MPOA) form empowers you, as the principal, to designate an agent who will make critical healthcare decisions on your behalf should you become incapacitated and unable to communicate your preferences. This legal document becomes fully effective only after a licensed physician certifies your incapacity.

Table of Contents

Statutory Forms – by State

You can find the official name below, as the name of the form differs by state.

State Official Name by State Laws
Alabama Advance Directive § 22-8A-4(c)(4)
Alaska Advance Health Care Directive AS 13.52.010
Arizona Health Care Power of Attorney § 36-3224
Arkansas Durable Power of Attorney for Health Care § 20-6-103
California Advance Health Care Directive PROB § 4701
Colorado Durable Power of Attorney for Healthcare Decisions § 15-14-506
Connecticut Advance Directive Sec. 19a-575a
Delaware Advance Health Care Directive § 2505
Florida Designation of Health Care Surrogate § 765.202(1)
Georgia Advance Directive for Health Care § 31-32-4
Hawaii Advance Health Care Directive § 327E-16
Idaho Living Will and Durable Power of Attorney § 39-4510
Illinois Power of Attorney for Health Care 755 ILCS 35/3(b)
Indiana Health Care Power of Attorney 755 ILCS 45/Art. IV
Iowa Durable Power of Attorney for Health Care Decisions § 144B.5
Kansas Durable Power of Attorney for Health Care § 58-632
Kentucky Living Will Directive and Health Care Surrogate Designation § 311.629
Louisiana Advance Directive RS 28:223
Maine Health Care Advance Directive Form § 5-805
Maryland Advance Directive § 5-603
Massachusetts Health Care Proxy § 201D-2
Michigan Durable Power of Attorney for Health Care § 700.5501(b)
Minnesota Health Care Directive § 145C.16
Mississippi Advance Health-Care Directive § 41-41-209
Missouri Durable Power of Attorney for Health Care § 404.822
Montana Durable Power of Attorney for Health Care § 53-21-1304
Nebraska Power of Attorney for Health Care § 30-3404
Nevada Durable Power of Attorney for Health Care Decisions NRS 162A.860
New Hampshire Advance Directive Section 137-J:20
New Jersey Durable Power of Attorney for Health Care § 26:2H-57
New Mexico Power of Attorney for Health Care § 24-7A-4
New York Health Care Proxy PBH § 2981
North Carolina Health Care Power of Attorney § 90-321
North Dakota Health Care Directive § 23-06.5-17
Ohio Durable Power of Attorney for Health Care Section 1337.17
Oklahoma Durable Power of Attorney § 63-3101.4
Oregon Advance Directive ORS 127.527
Pennsylvania Durable Health Care Power of Attorney § 5471
Rhode Island Designation of Health Care Agent § 23-4.10-2
South Carolina Health Care Power of Attorney § 62-5-504
South Dakota Durable Power of Attorney for Health Care § 59-7-2.1
Tennessee Durable Power of Attorney for Health Care § 68-11-1803(b)
Texas Medical Power of Attorney § 166.161
Utah Advance Health Care Directive § 75-2a-117
Vermont Durable Power of Attorney for Health Care 18 V.S.A. § 9703
Virginia Advance Directive for Health Care § 54.1-2984
Washington Durable Power of Attorney for Health Care § 11.125.100
West Virginia Medical Power of Attorney § 16-30-4
Wisconsin Power of Attorney for Health Care § 155.30
Wyoming Medical Power of Attorney § 35-22-403

Signing Requirements

States have different requirements for MPOA forms to be witnessed, but they need to be authorized in the presence of witnesses, a notary public, or both. This is the requirement that your signature be witnessed.

State Signing Requirements Laws
Alabama Two (2) Witnesses § 22-8A-4
Alaska Notary Public or Two (2) Witnesses AS 13.52.010
Arizona Notary Public or One (1) Witness § 36-3224
Arkansas Notary Public or Two (2) Witnesses § 20-6-103(b)
California Notary Public or Two (2) Witnesses § 4701
Colorado No law (Notary Public recommended) § 15-14-506
Connecticut Two (2) Witnesses § 19a-575
Delaware Two (2) Witnesses § 2503
Florida Two (2) Witnesses §765.202 – §765.205
Georgia Two (2) Witnesses § 31-32
Hawaii Notary Public and Two (2) Witnesses §327E-3
Idaho No law (Notary Public recommended) §39-4510
Illinois One (1) Witness 755 ILCS 45/Art. IV
Indiana One (1) Witness § 16-36-1-7(b)(3)
Iowa Notary Public or Two (2) Witnesses Chapter 144B
Kansas Notary Public and Two (2) Witnesses § 58-625
Kentucky Notary Public or Two (2) Witnesses § 311.621 -643
Louisiana Two (2) Witnesses § 224 (A)
Maine Two (2) Witnesses § 5-802 and § 5-804
Maryland Two (2) Witnesses § 5-601, § 5-602, and § 5–603
Massachusetts Two (2) Witnesses Chapter 201D
Michigan Two (2) Witnesses § 700.5506 to § 700.5515
Minnesota Notary Public or Two (2) Witnesses Chapter 14 C
Mississippi Notary Public or Two (2) Witnesses § 41-41-201 to § 41-41-229
Missouri Notary Public § 404.800 to § 404.865
Montana Two (2) Witnesses § 50-9-103
Nebraska Notary Public or Two (2) Witnesses Chapter 30 § 3401-3432
Nevada Notary Public or Two (2) Witnesses NRS 162A.(700-865)
New Hampshire Notary Public or Two (2) Witnesses Section 137-J
New Jersey Notary Public or Two (2) Witnesses § 26:2H-(53-77)
New Mexico Two (2) Witnesses § 24-7A
New York Two (2) Witnesses PBH Article 29-C
North Carolina Notary Public and Two (2) Witnesses § 32A, Article 3
North Dakota Notary Public or Two (2) Witnesses Chapter 23-06.5
Ohio Notary Public or Two (2) Witnesses § 1337.11-1337.17
Oklahoma Two (2) Witnesses Title 63, Chapter 60
Oregon Notary Public or Two (2) Witnesses § 127.505(-525)
Pennsylvania Two (2) Witnesses Chapter 54, Subchapters B and C
Rhode Island Notary Public or Two (2) Witnesses § 23-4.10-2
South Carolina Notary Public and Two (2) Witnesses Title 62, Article 5
South Dakota Notary Public or Two (2) Witnesses Chapter 34-12C
Tennessee Notary Public or Two (2) Witnesses Title 34, Chapter 6, Part 2
Texas Notary Public or Two (2) Witnesses Title 2, Chapter 166
Utah One (1) Witness Title 75, Chapter 2a
Vermont Two (2) Witnesses § 9703(b)
Virginia Two (2) Witnesses Title 54.1, Chapter 29, Article 8
Washington Notary Public or Two (2) Witnesses § 11.125.400
West Virginia Notary Public and Two (2) Witnesses Chapter 16, Article 30
Wisconsin Two (2) Witnesses Chapter 155
Wyoming Notary Public or Two (2) Witnesses § 35-22-403

How to Obtain a Medical Power of Attorney

Creating a legally sound MPOA involves a few essential steps:

Step 1 – Choose Your Agent:

Select an agent who is at least 18 years old, mentally competent, and not affiliated with your healthcare facility. This person, whether a friend, family member, spouse, or professional, should be someone you trust to advocate for your well-being, understand your medical preferences, and be emotionally capable of making challenging decisions on your behalf.

Step 2 – Define Your Agent’s Authority:

Clearly outline the scope of your agent’s authority in the MPOA. Without specific limitations, your agent will have the power to make decisions regarding your medical care, treatments, medications, surgeries, and more. This includes crucial choices related to life support, tube feeding, CPR, admission or discharge from healthcare facilities, medical research, palliative care, and organ or tissue donation.

Step 3 – Include Living Will or DNR:

Attach other Advance Directives, such as a Living Will or a Do-Not-Resuscitate form, to your MPOA. This ensures that your agent and healthcare professionals have easy access to detailed healthcare wishes. While an MPOA designates an agent to make decisions, a Living Will outlines your preferences for specific life-sustaining and end-of-life medical treatments.

Step 4 – Sign and Distribute Copies:

Ensure your MPOA complies with your state’s signing requirements for legal validity. Once properly signed, distribute copies to your primary agent, alternate agent, primary physician, loved ones, healthcare institutions, and residential/palliative care facilities where you receive care. Carry a copy with you, even for outpatient procedures, and file the original in your records.

MPOA vs. Living Will

It's essential to distinguish between Medical Powers of Attorney and Living Wills:

Medical Power of Attorney (MPOA):

  • Appoints an agent to make healthcare decisions when you are incapacitated.
  • Covers a broad range of medical decisions and treatments.
  • Effective in situations of temporary incapacitation with expected recovery.

Living Will:

  • Outlines specific preferences for life-sustaining and end-of-life medical treatments.
  • Doesn’t appoint an agent to make decisions.
  • Effective when diagnosed as terminally ill, permanently unconscious, or in a similar end-stage condition.

Understanding the distinctions allows individuals to create a comprehensive estate plan that aligns with their healthcare preferences.

By following these steps, you ensure that your Medical Power of Attorney is legally binding and that your healthcare decisions are in the hands of a trusted advocate should the need arise. Always stay informed about your state’s requirements to guarantee the validity of your MPOA.

Frequently Asked Questions

Does a Medical Power of Attorney have to be notarized?

Most states require you to sign the document in the presence of two witnesses or a notary public, and some states require both.

You can choose between a notary public or two witnesses in California and Texas. For example, Florida requires two witnesses’ signatures. Meanwhile, there are no requirements in Colorado. Nonetheless, we still recommend a notary public.

Your state may also impose restrictions on who can act as your witness. For instance, someone related to you by blood or marriage and/or your healthcare providers may be barred from signing as a witness.

Is a notary public required for a Medical Power of Attorney?

The necessity of a notary public varies by state. Some states may require notarization, while others may accept signatures from two witnesses. It's essential to be aware of your state's specific requirements.

Can I appoint a family member who is a healthcare provider as my agent?

In many states, someone related to you by blood or marriage and/or your healthcare providers may be restricted from acting as witnesses or agents. It's crucial to check your state's regulations.

Medical Power of Attorney Sample

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Related Will & Estate Planning Contracts
  • Do Not Resuscitate : Use our DNR Form if you don’t want cardiopulmonary resuscitation (CPR) if your heart stops, or you stop breathing.
  • Last Will and Testament : Utilize our Last Will and Testament to formally express your desires regarding the distribution of your assets and the management of your affairs following your passing.
  • Texas Medical Power of Attorney : Utilize our Texas medical power of attorney form to appoint someone else to make medical decisions on their behalf.
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