Download Health Care Power of Attorney Form for Free | Page 6

The Health Care Power of Attorney Form is a legal document that entrusts someone else to act on behalf of you to make decisions related to health care. Usually, the agent will make decisions in place of you when you are unable to do so. It is vital for you to choose a trusted agent for yourself. The agent can be your spouse, family members or even friends. In case that the agent cannot make decisions one day, you had better choose one more person as the alternative. Whoever is in need of this form can download it from our website for free.

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Giving Someone a Power of Attorney

For Your Health Care

The form in this guide is a simple version of a Health Care Advance Directive. It allows

you to choose someone to make health care decisions for you if you can’t. If you name a

health care agent when you are healthy, you will make sure that someone you trust can

make health care decisions for you if you become too ill or injured to make them

yourself.

To properly use the form, you must do 3 things:

1

Think carefully about the person you may choose to be your health care

agent.

2

Think about what guidance you want to give your health care agent in

making treatment decisions for you. Then talk about your decisions.

3

Fill out the form, A Power of Attorney for My Health Care, and follow the

instructions for signing it in the presence of 2 witnesses.

Health Care Power of Attorney Form Page 6

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