Medical Power of Attorney Forms

A Medical Power of Attorney form, a specific type of advance directive, is a binding legal document that allows a person to transfer authority over their healthcare matters to another person. This typically happens when an individual anticipates they will not be able to make rational decisions regarding their healthcare with a sound mind.

What Is a Medical Power of Attorney

A Medical Power of Attorney or an MPOA is an official document that grants an individual the power to preside over matters concerning another’s healthcare, unlike a general power of attorney. Some states have other official names for this same document, such as:

  • Healthcare Power of Attorney
  • Healthcare Proxy
  • Durable Power of Attorney for Healthcare
  • Advance directive
  • Advance healthcare directive
  • Medical power of attorney directive

The individual creating the MPOA is known as the principal, and the person receiving authority over the principal’s health is called the agent. In MPOAs, the agent is also called a healthcare agent, healthcare surrogate, or a healthcare proxy.

The agent acts on behalf of the principal and can decide on issues pertaining to their medical treatment plans, drug prescription plans, decisions regarding life support, donating organs post-death, and even after-life care, depending on what is specified in the document. This also includes being in touch with the doctors and professionals in charge of the principal’s treatments to uphold the patient’s wishes. 

A person typically creates this document in anticipation of medical issues, cognitive or physical decline, or when one has been diagnosed with a terminal illness. It is used when the principal becomes incompetent or incapacitated and will not be in a position to ensure their healthcare is carried out according to their wishes. 

A medical POA ensures that the principal’s wishes regarding their healthcare are not violated, and they will receive the type of care they want rather than being forced to undergo treatments they do not want. 

How to Write a Medical Power of Attorney

Here are the steps to writing an effective MPOA:

1. Date, Name, Location

As with any other POA, you will need to mention the date of its creation. You will also have to identify the name of the principal, i.e., the person wishing to give up the agency of presiding over their healthcare, and the name of the agent, i.e., the person receiving the permission. Both the principal and agent’s locations will need to be specified as mandated by law. 

2. List health care actions

In this section of the MPOA, the principal must list every specific or broad action they will want the agent to take over or handle for them. Remember, you are giving someone control over your own health and well-being, so the more specific, the better. These actions could include: 

  • Having access and control over the principal’s medical and personal information
  • Hiring or discharging doctors, nurses, and professional medical experts and compensating them for their services on behalf of the principal
  • Giving informed consent or refusal on the principal’s behalf with respect to medical care, diagnostic, surgical, or therapeutic procedures
  • Deciding on the continuity of treatment if there are no signs of healing or improvement
  • Deciding on intravenous feeding 
  • If life support should be discontinued
  • Whether or not organs should be donated after death

3. Date and time of effect 

In this section, the principal needs to mention when the MPOA will come into effect. It could be right after both parties have signed the form or later when the principal’s mental health deteriorates.  

4. Define limitations, instructions, and signature

You may not wish to give up control over some aspects of your healthcare. Or, you might have specific instructions regarding your treatment that need to be mentioned for your healthcare proxy or agent to make informed decisions. You can state all of these limitations and specifications to ensure a solid MPOA that will safeguard your best interests.  

The final element of writing an MPOA is signing the document. An MPOA must be signed by the principal, the agent, and a notary or witnesses, depending on the state you live in. Each state has different laws about signage requirements.

Medical Power of Attorney Laws by State

Steps Involved In Creating A Medical Power of Attorney

1. Choosing a health care proxy

Choosing a trustworthy agent is paramount when creating an MPOA form. You must choose someone who knows your health history and has your best interests at heart. With such high stakes, it is not surprising that most people appoint immediate family, namely their spouse or children, as their health care agents. Another alternative is to appoint multiple health care agents.

Before signing any official documents, have a clear conversation with your agent about your healthcare wishes. Make sure your agent is also willing to make tough decisions for you.

Choosing a health care proxy

2. Acquire the form

You can use our MPOA generator to start your document, which gives you a printable template to work from. But, before filing the document, ensure it is in PDF, DOC, or ODT format in order for it to be valid in your state.

Acquire the form

3. Specify powers to be undertaken by the agent

As you are already aware, you will need to chalk out all the areas of control you are ready to relinquish to your agent. This could be hyper-specific instructions such as your preferred drugs or medications or broader instructions about after-life care. Be as specific about your treatment as possible. 

As the principal, you also need to specify the time you want the MPOA to become effective. When this time comes, the agent will have the power to start taking charge of your medical matters. 

Since the stakes are much higher with an MPOA than with a financial POA, ensure you enlist an alternate agent as a backup should the primary agent refuse to make decisions on your behalf. Choose someone who can make a tough call, even in the face of emotional stressors.

Specify powers to be undertaken by the agent

4. Proper signage

Comply with your state’s requirements for the proper signage of your MPOA. Most states need notarization and one or two witnesses for the MPOA to be valid. Check the table below for more details.

Proper signage

5. Storing the MPOA

Store this form in a safe place and make copies. Apart from you, someone trusted should also know that the MPOA exists and where it is stored.

Storing the MPOA

Medical Power of Attorney FAQs

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