Free Medical Power of Attorney

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(e.g. James Tiberius Smith)
(e.g. 47 Grosvenor Avenue)
Frequently Asked Questions

What is a Living Will (Health Care Directive)?A Living Will or Health Care Directive is a written document that outlines a person's wishes with regard to life support and other health care treatment. Usually a Living Will is used when a person is no longer able to communicate.

A Living Will is very helpful if you have specific beliefs or preferences concerning medical treatment especially when you are preparing for serious surgery or are suffering from a terminal condition.
What are the benefits of a Living Will?Preparing a Living Will is very helpful if you have specific beliefs or preferences concerning medical treatment, especially if you are concerned that your family and friends may not hold the same beliefs.

Preparing a Living Will gives you a chance to discuss your treatment options with your family and health care practioners and explain your choices. This may help avoid conflicts among your family and friends when the time comes for decisions about your medical treatment.
What is the difference between a Living Will and a Last Will?A Last Will is used to distribute your property after your death. A Living Will allows you to specify, in writing, your health care preferences for the time when you no longer have capacity to provide consent. A Last Will cannot be used to specify what type of medical treatment you prefer.What is a Medical Power of Attorney or Power of Attorney for Health Care?A Medical Power of Attorney or Power of Attorney for Health Care is a written document that authorizes someone else to make medical decisions for you when you are no longer able.
Your Medical Power of AttorneyUpdate Preview



I revoke any prior Durable Power of Attorney for Health Care.







September 30, 2014


____________________, ____________________


Record of people and institutions to whom I have given a signed copy of this document:

1. ____________________________________  Date: ____________________
2. ____________________________________  Date: ____________________
3. ____________________________________  Date: ____________________
4. ____________________________________  Date: ____________________
5. ____________________________________  Date: ____________________



Record of people and institutions to whom I have given a signed copy of this document:

1. ____________________________________  Date: ____________________
2. ____________________________________  Date: ____________________
3. ____________________________________  Date: ____________________
4. ____________________________________  Date: ____________________
5. ____________________________________  Date: ____________________

Health Care Directive

What is a Health Care Directive?

A Health Care Directive is comprised of a Living Will and Medical Power of Attorney.

A directive allows you to plan your medical treatment in advance should there ever comes a time when you are unable to express your personal health care wishes.

A Health Care Directive is also known as:

  • Advance Directive
  • Personal Directive
  • Advance Decision
  • Medical Directive
  • Living Will

What is a Medical Power of Attorney?

A Medical Power of Attorney is a document used to appoint someone to make medical decisions on your behalf.

A Medical Power of Attorney is also known as:

  • Health Care Power of Attorney
  • Health Care Proxy
  • Durable Power of Attorney for Health Care
  • Health Care Representative

What is a Living Will?

A Living Will is a document that you use to indicate your medical wishes in the event you are incapacitated or cannot consent to your health care treatment.

Living Will vs. Last Will and Testament

If you are unable to express your health care wishes in the future, hospitals and family will reference your Living Will as a statement of your medical wishes.

Alternatively, a Last Will and Testament is a document used to indicate how you would like your assets divided or children cared for after your death. You cannot specify medical treatment preferences with a Last Will.

Why should I create a Health Care Directive?

Without a Living Will, the burden of making your medical decisions falls on your family members. Creating a personal directive not only gives you control of your medical wishes but it saves your family from making tough treatment choices on your behalf.

Additionally, appointing a Medical Power of Attorney allows you to discuss your treatment wishes with someone you trust prior to any unforeseen medical circumstance so they can make health care decisions in your best interest.

Choosing a Medical Power of Attorney/Health Care Proxy

When appointing someone as your Medical Power of Attorney, you should choose someone who is trustworthy, has your best interests in mind, and will make your health care decisions according to your intended wishes.

What medical decisions can I make with a Living Will?

Every state has its own limits as to what you are legally permitted to include in your directive. While you may specify instructions for a variety of medical situations and describe your feelings towards quality of life, keep in mind health care providers will only be allowed to carry out certain procedures according to your state laws.

Here are some of the main treatment choices you will want to specify in your Living Will:

Life Support

Life Support means any life-sustaining procedures done to a patient to restore function to an organ through medical intervention.

Common forms of life support include CPR (Cardiopulmonary Resuscitation), defibrillators, assisted breathing, dialysis, and artificially administered food and water.

DNR is short for "Do Not Resuscitate", which means you do not wish to receive life support or resuscitation if an organ fails.

Comfort Care

Comfort care means healthcare professionals will use any means possible to relieve your pain, including administering medication or creating a comfortable environment for you to rest in.

Quality of Life

Many people define quality of life in their Living Will to notify their family and health care professionals as to what they may want in extreme health situations (life or death) and what constitutes a quality life for them.

When does my Health Care Directive come into effect?

The terms of your directive are binding once you sign the document. It comes into use when you have been found to be incapable of making your own medical decisions. Typically, this may be when you are incapacitated, in a coma, or in a vegetative state.

Can I make changes to my Health Care Directive?

You can make changes to your personal directive if you destroy your current one, notify your health care representative or hospital of your changes, and create and distribute a new directive. It's important to let everyone in your family know where you keep your advance directive so they can easily find it during an emergency.

Related Documents:

  • Power of Attorney: A document used to grant someone the authority to act on your behalf, such as tending to your finances or maintaining property.
  • Last Will and Testament: A document specifying how you would like your estate divided upon your death.
  • Child Medical Consent: A form granting a guardian the authorization to make medical decisions on behalf of your child.
  • Medical Records Release: A form requesting your medical records be released to you or a third party.
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