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Medical Power of Attorney

Durable power of attorney specifically for healthcare decisions, granting broad authority to the appointed agent to make medical choices.

PDF TemplateUse the instructions below to complete this form

Instructions

Name the agent and specify the scope of authority (all medical decisions or limited categories). The power activates upon a determination of incapacity by the attending physician. Include HIPAA authorization allowing the agent to access medical records. Sign before witnesses and notarize as required by your state. File with your primary care physician and the designated agent. This document may be revoked at any time while you have capacity.