Free medical power of attorney form pdf

Except to the extent you state otherwise, this document gives the person you name as your agent the authority to make any and all health care decisions for you in accordance with your wishes, including your religious and moral beliefs, when you are no longer capable of making them yourself.

Power of attorney is a designation given to an agent to handle financial or medical acts on someone else’s behalf. The person giving permission, known as the principal, can also choose to have the agent continue to operate on their behalf even if they should become incapacitated (known as durable power of attorney).

Table of Contents

  • Power of Attorney Forms: By State
  • Power of Attorney Forms: By Type (9)
  • How to Get Power of Attorney
    • Choose an Agent
    • Select Your Power of Attorney
    • Signing Requirements
    • Holding and Accessing Original Copies
    • Canceling Power of Attorney
  • Why Have Power of Attorney?
    • Financial Affairs
    • Medical Affairs
    • Other Instances
By State
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
By Type (9)

Free medical power of attorney form pdf

Durable ($) Power of Attorney – To grant power to bank accounts, real estate, and any other financial-related acts. The powers are durable which means the form remains valid even if the principal should become mentally incompetent.

Download: Adobe PDF, MS Word (.docx)

Free medical power of attorney form pdf

General ($) Power of Attorney – Grants identical financial powers as the durable version. Although, the general power of attorney is no longer valid if the principal becomes mentally incompetent.

Download: Adobe PDF, MS Word (.docx)

Free medical power of attorney form pdf

IRS Power of Attorney (Form 2848) – To hire or allow someone else to file federal taxes to the Internal Revenue Service on your behalf.

Download: Adobe PDF

Free medical power of attorney form pdf

Limited Power of Attorney – For any non-medical power. This is common for one-time instances such as picking up mail, borrowing a vehicle, or staying at someone else’s home.

Download: Adobe PDF, MS Word (.doc)

Free medical power of attorney form pdf

Medical Power of Attorney – Referred to as an “Advance Directive,” which allows someone to act as a health care surrogate and make decisions based on the patient’s wishes.

Download: Adobe PDF

Free medical power of attorney form pdf

Parental (Minor) Power of Attorney – To give health and educational powers to someone else over the caretaking of one’s child.

Download: Adobe PDF, MS Word (.docx)

Free medical power of attorney form pdf

Real Estate Power of Attorney – For the buying, selling, renting, or occupying someone else’s property.

Download: Adobe PDF, MS Word (.docx)

Free medical power of attorney form pdf

Revocation Power of Attorney – To cancel or void a power of attorney document.

Download: Adobe PDF

Free medical power of attorney form pdf

State Tax Power of Attorney – Just like IRS Power of Attorney except for State Tax purposes. Elect someone else to handle the filing of personal and corporate tax records to the State’s Dept. of Revenue.

How to Get Power of Attorney (5 Steps)

An individual may get power of attorney for any type in five (5) easy steps:

Step 1 – Choose an Agent

Free medical power of attorney form pdf

Select and ask someone that you trust if they would like to be your “Agent” or “Attorney-in-Fact”. Especially for a durable power of attorney, the agent selected should be someone you have trusted most of your life.

Step 2 – Select Your Power of Attorney

Free medical power of attorney form pdf

Choose from one of the following nine (9) types:

  • Durable ($) – Financial only. Remains in-effect if the Principal becomes *incapacitated.
  • General – Financial only. It does not remain in effect if the Principal becomes *incapacitated.
  • IRS (2848) – Federal tax filing with the Internal Revenue Service.
  • Limited – Special activity or task.
  • Medical – Health care decision-making only. It becomes active only when the Principal becomes *incapacitated.
  • Parental – Minor’s education, health, and everyday care. Most States limit this to a maximum of one (1) year.
  • Real Estate – Sale, purchase, or maintaining the property. Mostly used for real estate closings.
  • Revocation – To terminate or cancel a current power of attorney document.
  • State – Elect someone else to pay state taxes on your behalf (Dept. of Revenue).

*Incapacitation is defined as not being able to make rational and cognitive decisions knowing full-well of the consequences of such decided actions.

Step 3 – Signing Requirements

Free medical power of attorney form pdf

After completing, you and the Agent(s) selected will need to check the bottom of the form for the requirements for authorization. In most cases, a Notary Public will need to be used or Two (2) Witnesses.

STATE

DURABLE

GENERAL

MEDICAL

MINOR (CHILD)

REAL ESTATE

TAX

VEHICLE

Alabama

Notary Public

Notary Public

2 Witnesses

Notary Public

Notary Public

Principal Only

Notary Public

Alaska

Notary Public

Notary Public

Notary Public

Notary Public or 2 Witnesses

Notary Public

Principal Only

Notary Public

Arizona

Notary Public and 1 Witness

Notary Public and 1 Witness

Notary Public or 1 Witness

Notary Public and 1 Witness

Notary Public and 1 Witness

Principal Only

Notary Public

Arkansas

Notary Public

Notary Public

Notary Public and 2 Witnesses

Notary Public

Notary Public

Principal Only

Principal Only

California

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Principal Only

Principal Only

Colorado

Notary Public

Notary Public

Principal Only (Notary Public and 2 Witnesses Recommended)

Notary Public

Notary Public

Principal Only

Notary Public

Connecticut

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Principal Only

Notary Public and 2 Witness

Delaware

Notary Public and 1 Witness

Notary Public and 1 Witness

2 Witnesses

Notary Public and 1 Witness

Notary Public and 1 Witness

N/A

Notary Public

Florida

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Principal Only

Principal Only

Georgia

Notary Public and 1 Witness

Notary Public and 1 Witness

2 Witnesses

Notary Public

Notary Public and 1 Witness

Principal Only (Notary Public and 2 Witnesses in Certain Circumstances)

Notary Public

Hawaii

Notary Public

Notary Public

Notary Public and 2 Witnesses

Notary Public

Notary Public

Principal and Representative

Notary Public

Idaho

Notary Public

Notary Public

Principal Only

Notary Public

Notary Public

Principal Only

Notary Public

Illinois

Notary Public and 1 Witness

Notary Public and 1 Witness

1 Witness

1 Witness (Only in Certain Circumstances)

Notary Public and 1 Witness

Principal and Representative (Witness or Notary Public in Certain Circumstances)

Principal Only

Indiana

Notary Public

Notary Public

1 Witness

Notary Public

Notary Public

Principal Only

Notary Public

Iowa

Notary Public

Notary Public

Notary Public and 2 Witnesses

Notary Public

Notary Public

Principal Only

Notary Public

Kansas

Notary Public

Notary Public

Notary Public or 2 Witnesses

Notary Public

Notary Public

Principal and Representative

Principal Only

Kentucky

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Notary Public

Notary Public and 2 Witnesses

Principal Only

Notary Public

Louisiana

Notary Public and 2 Witnesses

Notary Public or 2 Witnesses

2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Principal Only

Notary Public and 2 Witnesses

Maine

Notary Public

Notary Public

2 Witnesses

Notary Public

Notary Public

Principal Only

N/A

Maryland

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Principal Only

Principal Only

Massachusetts

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

2 Witnesses

2 Witnesses

Notary Public and 2 Witnesses

Principal Only (Notary Public or 2 Witnesses in Certain Circumstances)

N/A

Michigan

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Principal Only

Principal Only

Minnesota

Notary Public

Notary Public

Notary Public or 1 Witness

2 Witnesses

Notary Public

Principal Only

N/A

Mississippi

Notary Public

Notary Public

Notary Public or 2 Witnesses

Notary Public

Notary Public and 2 Witnesses

Principal Only

Notary Public

Missouri

Notary Public

Notary Public or 2 Witnesses

Notary Public

Notary Public

Notary Public

Principal Only

Notary Public

Montana

Notary Public

Notary Public

2 Witnesses

Notary Public

Notary Public

Principal Only

Notary Public

Nebraska

Notary Public

Notary Public

Notary Public and 2 Witnesses

Notary Public

Notary Public

Principal Only

Notary Public

Nevada

Notary Public

Notary Public

Notary Public or 2 Witnesses

Notary Public

Notary Public

N/A

Notary Public

New Hampshire

Notary Public

Notary Public

Notary Public or 2 Witnesses

Notary Public

Notary Public

Principal Only (2 Witnesses in Certain Circumstances)

Notary Public

New Jersey

Notary Public

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

2 Witnesses

Notary Public

Principal and Representative

Notary Public

New Mexico

Notary Public

Notary Public

2 Witnesses (Optional)

Notary Public

Notary Public

Principal Only

Notary Public

New York

Notary Public

Notary Public

2 Witnesses

Notary Public

Notary Public

Principal Only (Notary Public or 2 Witnesses in Certain Circumstances)

N/A

North Carolina

Notary Public

Notary Public

Notary Public and 2 Witnesses

Notary Public

Notary Public

Principal Only

Notary Public

North Dakota

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public

Notary Public

Prinipal Only

N/A

Ohio

Notary Public

Notary Public

Notary Public or 2 Witnesses

Notary Public

Notary Public

Principal Only

Notary Public

Oklahoma

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

2 Witnesses

Notary Public

Notary Public and 2 Witnesses

Principal Only

N/A

Oregon

Notary Public or 2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Notary Public

Notary Public

Principal Only

Principal Only

Pennsylvania

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Principal Only

N/A

Rhode Island

Notary Public or 2 Witnesses

Notary Public

Notary Public or 2 Witnesses

Notary Public

Notary Public

Notary Public or 2 Witnesses

N/A

South Carolina

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Notary Public and 2 Witnesses

Principal Only

N/A

South Dakota

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public

Notary Public

Notary Public

Notary Public

Tennessee

Notary public and 2 Witnesses

Notary Public and 2 Witnesses

Notary Public or 2 Witnesses

Notary Public

Notary Public and 2 Witnesses

Principal and Representative

Notary Public

Texas

Notary Public

Notary Public

Notary Public or 2 Witnesses

2 Witnesses

Notary Public

Principal Only

Principal Only

Utah

Notary Public

Notary Public

1 Witness

Notary Public

Notary Public

Principal Only

N/A

Vermont

Notary Public and 1 Witness

Notary Public and 1 Witness

2 Witnesses

Parents Only

Notary Public and 1 Witness

Notary Public and 1 Witness

N/A

Virginia

Notary Public

Notary Public

2 Witnesses

Notary Public

Notary Public

Principal and Representative

Principal Only

Washington

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Notary Public or 2 Witnesses

Principal Only

N/A

West Virginia

Notary Public

Notary Public

Notary Public and 2 Witnesses

Notary Public

Notary Public

Notary Public or 2 Witnesses

Notarty Public

Wisconsin

Notary Public

Notary Public

2 Witnesses

Notary Public (Witness Optional)

Notary Public

Principal Only

N/A

Wyoming

Notary Public

Notary Public

Notary Public or 2 Witnesses

Notary Public

Notary Public

N/A

N/A

Step 4 – Holding and Accessing Original Copies

Free medical power of attorney form pdf

It is important for all parties involved to have copies of their form. A power of attorney does not need to be recorded with any government office and is primarily held by the Principal and Agent(s).

Step 5 – Cancelling Power of Attorney

Free medical power of attorney form pdf

A Principal may terminate this arrangement by signing a Revocation Form. Otherwise, it will only cancel upon the death of the Principal.

Why Have Power of Attorney?

Accidents happen. Any person who should become incapacitated through an accident or illness would need to make arrangements beforehand for their financial and medial affairs.

Financial Affairs 

A durable or general power of attorney allows for any type of financial transaction to be handled by someone else. The financial transactions include, but are not limited to,

  • Real Property;
  • Personal Property;
  • Stocks and Bonds;
  • Commodities and Options;
  • Bank Accounts;
  • Business Entity;
  • Insurance and Annuities;
  • Estates and other Beneficial Interests;
  • Claims and Litigation;
  • Taxes; and
  • Retirement Plans.

Medical Affairs

An advance directive, referred to as a “living will” or “medical power of attorney”, lets someone else handle health care decisions on someone else’s behalf and in line with their wishes. These powers include:

  • Everyday medical decision-making;
  • End-of-life decisions;
  • Donation of organs;
  • The nomination of a Conservator; and
  • Autopsy authorizations.

Other Instances

For other nominations, a principal may assign power of attorney under a special circumstance with the limited form. In addition, if the principal is looking to have someone only handle personal and business filings, a tax power of attorney should be used.

How do I get a medical power of attorney in Tennessee?

How do I get Medical Power of Attorney in Tennessee?.
Make your document - Provide a few basic details and we will do the rest..
Send and share - Review the document with your agent or seek legal help..
Sign and make it legal - Mandatory or not, witnesses/notarization are encouraged..

How do I get a medical power of attorney in Georgia?

A POA must meet all four of the following basic requirements for a power of attorney in Georgia:.
It must be signed by the principal. ... .
It must be signed by one or more witnesses..
It must be signed by a notary public or other person authorized to administer oaths..

How do I get a medical power of attorney in Oklahoma?

How to Write.
1 – Obtain The Paperwork On This Page To Grant Durable Health Care Powers. ... .
2 – Present An Introduction Of The Principal And Health Care Attorney-in-Fact. ... .
4 – Assign the Primary Health Care Powers The Agent Should Have. ... .
5 – Discuss The Principal Preferences..

How do I get a medical power of attorney in Wisconsin?

How to Write.
Step 1 – Acquire The Wisconsin Power Of Attorney For Health Care. ... .
Step 2 – Review The Preliminary Information Presented By this Document. ... .
Step 3 – Attach A Document Date To This Wisconsin Authority. ... .
Step 4 – Present The Wisconsin Principal's Identity..