Health Care Power of Attorney Form
A health care power of attorney form determines the individual that will supersede the decisions that would otherwise be made by the client in health care matters. In case an individual is not healthy enough to make decisions, they will require an agent to make health decisions on their behalf. A sample health care power of attorney form is shown below.
Sample Health Care Power of Attorney Form
I, (name) _______________________________agree to hand over health care power of attorney to the agent: (name) ______________________________ in the event that I am not in the capacity to make health care decisions. I consent to giving them absolute power to make critical decisions that will affect my health care.
This document is binding and once signed will be recognized under the eyes of the law. Both parties have signed this document with a sound state of mind and under no coercion
Signed (client):_____________________
Signed (agent):_____________________
Date Signed: _____________________
Category: Power of Attorney forms
