What is a Medical Power Of Attorney Form?

If a person is unable to make decisions or think for themselves regarding medical stuff, they will need help from someone else to help them; in these cases, a Medical Power of Attorney form is very useful and recommended.

This document gives the legal power to an ‘agent’ (also known as ‘health care proxy’) to represent and authorize any medical resolutions on behalf of the person who has not stable mental or physical conditions.

For your convenience, we have gathered essential information about what this document is, when should you get it, and how to write it, so keep reading!

What is a Medical Power of Attorney form?

A Medical Power of Attorney form (also known as durable power of attorney for health care, medical POA, or health POA) is a legal document that authorizes someone to make medical decisions for you. This kind of power is only effective after being declared disabled and incapable of transmitting your own decisions to your doctor (e.g., if you get into a coma).

When should I get a Medical Power of Attorney form signed?

It would be wise to have a form filled and signed when you know you are having a risky medical procedure; by doing this, you get to choose who will make life-important decisions for you.

It is also recommended that people with disabilities complete this document since the situation may be more severe in the event of an accident.

Other people that should get a medical power of attorney form are those with degenerative diseases such as osteoporosis, dementia, Alzheimer’s disease, etc.; at some point, when their condition does not allow them to make decisions, they must have someone to support them.

Is a Living Will the same as a Medical Power of Attorney form?

A Living Will is a legal document in which you can indicate all the decisions you approve or not for your life -and your body- if you cannot express them. This includes everyday issues and health issues; for example, treatments you want to receive, whether you agree with organ donation or resuscitation, etc.

The Living Will is done based on specific scenarios, and generally, someone else is not empowered to make decisions, so be very clear when you write it.

On the other hand, a Medical Power of Attorney does imply a direct authorization to someone else to decide your health status. Make sure to delimit your ‘agent’ actions so that he or she cannot override or alter the Living Will.


Let’s say you have a degenerative disease like Alzheimer’s that will cause you to lose your memory at some point, and you also have respiratory problems.

In a Living Will, you can:

  • Indicate which medical center you want to attend when you lose your memory.
  • Whether or not you want an experimental procedure to combat the disease.
  • If you wish to receive respiratory assistance in case of an emergency.
  • If you want to donate your organs, etc.

In a Medical Power of Attorney, you can authorize a person that will decide things like:

  • Which medicines are best for your daily treatment.
  • Request another specialist’s evaluation.
  • Decide whether to donate your organs or not (in case you have not specified it in the living will), etc.
  • Here you can indicate anything within the limits of the living will and does not contradict it.

Another important difference is that a Living Will only takes effect after you are diagnosed as terminally ill or in an end-stage status by your medical staff. But, if your condition is only temporary, then the Medical Power of Attorney is the best option.

What to include in your Medical Power of Attorney form

The first thing you should do is choose your agent and what kind of decisions this person can make. The role of the agent is essential, so make sure you choose someone of your entire trust. You can also select more than one agent in case the one you chose is unavailable at the moment.

The second step is to fill your form complying with your state’s legal formalities. However, even though the format and requirements might vary, there is some basic information that you must provide (about you and your agent):

  • Full name.
  • City and state where you live.
  • Zip code.
  • Powers of your agent.
  • Special instructions or limitations.
  • Signatures.
  • A statement by your witness.
  • A statement by a notary.

Now, for your convenience, here is an example of a general Medical Power of Attorney form:

medical power of attorney, sample 1

medical power of attorney, sample 2

medical power of attorney, sample 3

DISCLAIMER: Remember that each state has a specific format for this document. We recommend you to look on this website and select the state where you live.

Once you complete this part, sign the form and make copies; deliver the copies to everyone involved and keep the originals. Although this document gets valid when you and your agent sign it, your agent will only make decisions after your physician declares you incapable.