Free Massachusetts Medical Power of Attorney Forms

POWER OF ATTORNEY FORMS

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A Massachusetts medical power of attorney (POA) form allows an individual (the principal) to appoint someone they trust (the agent) to make healthcare decisions on their behalf if they become incapacitated or incompetent.

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POWER OF ATTORNEY FORMS

icon/new-doc_24pxCreate your document

icon/edit-doc_24pxFill forms in a few steps

icon/download-doc_24pxPrint, and download you PDF

Massachusetts Medical Power of Attorney Laws

In Massachusetts, there are specific laws around this arrangement and how it can be executed:

  • Competent adults have the legal right to appoint an agent by executing a durable medical POA form. A written, signed healthcare proxy must be created in the presence of two other adults who will add their signatures as witnesses. The witnesses shall sign a statement certifying that the principal is at least 18 years old, of sound mind, and not under any constraint or undue influence. The appointed agent may not be a witness to the document's signing. All parties are presumed competent, and a healthcare proxy is assumed valid unless the court finds otherwise (Mass. Gen. Laws Ch. 201D, Section 2).
  • The agent shall have the power to make all healthcare decisions on behalf of the principal, including decisions about life-sustaining treatment (Mass. Gen. Laws Ch. 201D, Section 5).
  • If the attending physician determines that the principal has regained capacity, the authority of a healthcare agent shall cease. It will resume if the principal subsequently loses capacity (Mass. Gen. Laws Ch. 201D, Section 6).
  • A principal may revoke a medical POA agent at any time by notifying them or a healthcare provider orally, in writing, or by any other act evidencing a specific intent to do so (Mass. Gen. Laws. Ch. 201D, Section 7).

Signing Requirements in Massachusetts

The requirements for signing a power of attorney vary from state to state. In Massachusetts, the agent must be at least 18 years old. Additionally, the agent cannot be a witness when the document is signed.

How To Write a Medical POA in Massachusetts

Here are the simple steps for writing a medical power of attorney:

1. Obtain a medical POA printable form or template

You can obtain the paperwork to declare a medical POA at the hospital where you are being treated or at your local town hall. If you need help writing this agreement, consider hiring an attorney.

It may be even easier to download a printable medical POA template form and add your specific terms and your agent’s responsibilities.

2. Write the name of the principal and agent

This step presents the principal with a structured statement that names the healthcare agent or proxy who can make medical decisions when needed. The language presented on the form is relatively standard, so personal information must be included to make the document actionable.

3. List the scope of the agent’s authority

The power of attorney form gives the agent broad decision-making powers over healthcare decisions. The principal should clearly outline these crucial decisions before signing the document.

If there are any limitations that the principal wants to emphasize, make sure that they are indicated clearly in the form.

4. Sign the document

Section 3 of the form provides the standard language required to issue this power designation properly. The principal should read it, sign their name, and indicate the date.

In section 4 of the form, “Witness Statement,” the two witnesses who observed the principal signing the document must verify that they did so legally and ethically. It is customary for such signatures to be completed on the same day as the principal's signing.

Witness #1 and #2 will each have their own column to sign and print their names and addresses.

The primary healthcare agent must sign the “Health Care Agent” acknowledgment statement. If an alternate agent is appointed, they must sign on the indicated area before the document can be filed with the state government.

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