Available Adobe PDF Files to Download
Power of Attorney for Healthcare (English)
Power of Attorney for Healthcare (Spanish)
If you do not have Adobe Acrobat Reader, please click here to download the FREE version.
The healthcare power of attorney lets you choose someone to make healthcare decisions for you in the future, if you are no longer able to make these decisions for yourself. You are called the "principal" in the power of attorney form and the person you choose to make decisions is called your "agent." Your agent would make healthcare decisions for you if you were no longer able to makes these decisions for yourself. So long as you are able to make these decisions, you will have the power to do so. You may use a standard healthcare power of attorney form or write your own. You may give your agent specific directions about the healthcare you do or do not want.
The agent you choose cannot be your doctor or other healthcare provider. You should have someone who is not your agent witness your signing of the power of attorney.
The power of your agent to make healthcare decisions on your behalf is broad. Your agent would be required to follow any specific instructions you give regarding care you want provided or withheld. For example, you can say whether you want all life-sustaining treatments provided in all events; whether and when you want life-sustaining treatment ended; instructions regarding refusal of certain types of treatments on religious or other personal grounds; and instructions regarding anatomical gifts and disposal of remains. Unless you include time limits, the healthcare power of attorney will continue in effect from the time it is signed until your death. You can cancel your power of attorney at any time, either by telling someone or by canceling it in writing. You can name a backup agent to act if the first one cannot or will not take action. If you want to change your power of attorney, you must do so in writing.