A Medical Power of Attorney is a document that gives you the ability to name an individual to make healthcare decisions on your behalf should you become incapacitated. Your physician can’t be your Agent, and there are restrictions on many individuals professionally involved in your health care if they aren’t family. In choosing your Agent, local availability is important so that the individual may be able to show up at the health care facility within a moment’s notice.

In addition to the Medical Power of Attorney, you will need the Health Insurance Portability and Accountability Act (HIPAA) document. Without the HIPAA document, the Agent under your Medical Power of Attorney will not have access to your protected medical information to make a medical decision for you.

The Medical Power of Attorney document needs to be notarized -OR- signed by two witnesses. The HIPAA document needs to be notarized.

Click here to download and print a PDF of the Medical Power of Attorney questionnaire worksheet. This worksheet can be useful in your preparations to fill out the online questionnaire.