Medical Power of Attorney Form

What is a Medical Power of Attorney?

A Medical Power of Attorney (medical POA) is a trusted individual who steps in to make medical decisions on a patient's behalf, designating them as the "attorney in fact" (sometimes referred to as the health care proxy or health care agent) and essentially giving them the same authority as the patient in decision-making. This is needed when the patient has been deemed as mentally incapable by a suitably qualified medical professional, if they have not created a living will, or if their living will does not sufficiently provide preferences for their current situation. This means that the patient lacks capacity to make, understand, communicate and see the consequences of a medical decision.

A patient can have only have one other person acting as their Medical Power of Attorney at a time, although it is common for individuals to appoint a first alternate agent and second alternate agent in the circumstances that the primary agent is unable to act. Ideally, the primary agent should be someone familiar with your medical history, current health condition, treatment needs, and medications. They should understand the type of medical care and support required to ensure the patient's comfort and well-being and must always act in your best interests.

The patient's attorney holds a position of trust, legally referred to as a “fiduciary” relationship. This means they must act with honesty, fairness, and diligence, prioritizing your health and welfare above all else. They are required to work in the patient's best interests, making decisions to promote their health and protect your well-being.

What is a Medical Power of Attorney Form?

A Medical Power of Attorney Form is a legal document granting authority to a trusted individual to make medical decisions on your patient's behalf. It also includes safeguards that keep the health care provider from making decisions that benefit them over the patient, such as clauses that prohibit any business office employee or staff involved in providing direct patient care from being a witness.

The attorney must actively involve the patient in decisions about their medical care whenever possible. They are expected to consult with the patient about treatment options and encourage the patient to participate in decisions, leveraging any ability the patient has to make choices for their self. Their specific duties, restrictions and instructions are depend on what is specified in the Medical Power of Attorney Form as indicated by the individual.

A Medical Power of Attorney Form is seperate from a last will, and hence does not replace anyone that you have chosen as an executor or beneficiary in a will. When the individual dies, the individual no longer has any authority, and the will takes effect instead. The form however helps fill a gap in the patient's living will, if they have one.

How does a Medical Power of Attorney Form work?

Using our free downloadable Medical Power of Attorney Form template is straightforward and simple. Here's how to get started:

Step 1: Access the template

You can access the Medical Power of Attorney template by clicking "Use template. " This will allow you to edit the resource via the Carepatron app. To download a PDF copy, choose "Download."

Step 2: Explain how it works

Take the time to discuss how the template works with your patient. Make sure to answer any questions they may have before proceeding to the next steps.

Step 3: Have the patient fill out the letter

Ask the patient to fill in the necessary information, including their name, the agent's name, medical decisions the agent can make, and any special instructions.

Step 4: Have the patient sign the Medical Power of Attorney letter

Ask your patient to sign the form to officially authorize their chosen health care representative. By signing, the patient confirms their consent and the authority granted to the representative to act on their behalf in medical matters.

Step 5. Keep copies

Keep a copy of the completed form for your records. Share copies with your patient, attorney medical power, and the healthcare provider. Keep one accessible in an emergency.

When would you use this template?

This template is used to legally appoint a trusted individual to make healthcare decisions on your behalf when your patient cannot do so. You may also use our free Medical Power of Attorney Form to:

Appoint a guardian in case of incapacity

The Medical Power of Attorney can help your patient ensure their wishes and preferences are respected if they become incapacitated. It assigns a guardian who can make decisions on their behalf in the event of incapacity.

Grant access to health information

Our printable also allows the patient to grant access to their medical information and records. This enables the agent to make informed decisions about treatments and other medical matters.

Establish end-of-life wishes

This document can help your patient ensure that their end-of-life decisions are respected, including provisions for organ donation or refusal of treatments. They can also designate a trusted individual to make decisions regarding funeral arrangements.

Ensure smooth communication

The Medical Power of Attorney Form can facilitate smoother communication between the healthcare team and the designated agent. With this document, the agent can relay the patient's wishes accurately to primary care physician, attending physician, and other medical professionals, reducing misunderstanding and confusion during a critical time.

Provide peace of mind

Knowing that a trusted person is in place to make health care decisions can provide tremendous peace of mind for the patient. This document assures them that their healthcare preferences will be respected, even if they cannot voice them personally.

Benefits of free Medical Power of Attorney Form

Our free Medical Power of Attorney Form template offers numerous benefits to individuals and their designated agents, including the following:

It's easy to complete

The form is straightforward and simple to use. Just fill in the necessary information, sign it, and have a notary witness it for extra security.

It's legally binding

This form is a legally binding document when signed correctly by both parties. It's accepted by medical professionals, hospitals, and other healthcare entities that must follow the instructions outlined in the paper.

It can be customized

The can be personalized with specific details tailored to your patient's needs and healthcare preferences. This guarantees the utmost respect for all their decisions, even in the event of incapacitation or inability to communicate.