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health care power of attorney forms

Who’s going to take care of your legal, financial, and medical affairs if something happens to you and you are not mentally capable of making your own decisions?

Using Power of Attorney Forms, you can legally assign an “agent” or an “attorney-in-fact” chosen from among your closest friends, relatives, or trusted professionals – not necessarily your lawyer – who will make these decisions on your behalf.

There are different areas the agents can have authority in. If you are looking to assign an agent only with authority over your medical care, we have provided a list of free templates and samples you can easily download and use for this purpose.

Health Care Durable Power of Attorney Form

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File Format
  • PDF

Size: 39 KB

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Blank Health Care Power of Attorney Form

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File Format
  • PDF

Size: 90 KB

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Free Health Care Power of Attorney Form

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File Format
  • PDF

Size: 16 KB

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Generic Health Care Power of Attorney Form

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File Format
  • PDF

Size: 157 KB

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Understanding POA Types

These power of attorney (POA) forms which deal only with decisions concerning your medical care are part of the category of Limited Power of Attorney Forms.

POA can be of 2 types:

  • Limited power – Can exercise authority on your behalf only within a narrow scope you assign them; in this case, your healthcare (also called “special” power)
  • General power – Can exercise authority over a broad scope, dealing with everything from your medical to your financial, legal, and personal matters

Either of these kinds of POA can further be classified as enduring or conditional:

  • Enduring POA – Can exercise authority immediately even after the principal (i.e. you) is incapacitated (also called “durable” power)
  • Springing POA – Can exercise authority only after you are incapacitated (also called “conditional” power)

If you’re assigning an attorney-in-fact for your medical issues, it’s best to make sure they can act after you are physically and mentally incapable of deciding for yourself.

You’ll notice the first free sample we provided is a limited as well as durable POA form. This is a great, practical option, since the agent can act on your behalf, with your permission, if you are not incapacitated but are away (e.g. on military duty).

Advance Health Care Directive Form

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File Format
  • PDF

Size: 400 KB

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Living Will and Durable Power of Attorney for Health Care

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File Format
  • PDF

Size: 30 KB

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Printable Health Care Power of Attorney Form

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File Format
  • PDF

Size: 344 KB

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General Health Care Power of Attorney Form

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File Format
  • DOC

Size: 8.5 KB

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How to Use These Templates

  • Choose your template to suit your needs; download and print for free
  • Meet with your nominated agents and discuss this decision with them
  • Fill in the information on the template, get it signed and notarized in the presence of your agent(s) and a notary public
  • Give your agent(s) a copy of the completed, notarized form, and keep the original safe

Unless explicitly stated otherwise as springing, these are all Durable Power of Attorney Forms and come into effect as soon as they are signed.

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