A medical power of attorney (also called a health care power of attorney or health care proxy) names the person who makes medical decisions for you if illness or injury leaves you unable to decide for yourself. Without one, hospitals fall back on state surrogate lists or, in disputes, on a court-appointed guardian.
This template lets you name your agent and an alternate, decide whether they control life-sustaining treatment, and record guidance they must follow. Download it in Word and PDF, then sign it with the witnesses or notary your state requires.
Choosing your health care agent
Pick someone who knows your values, can handle pressure, and will advocate for you against pushback from providers or relatives. Availability matters: an agent who can be at the hospital within hours is worth more than a distant relative with better medical knowledge. Most states bar your attending physician and employees of your treating facility from serving as your agent. Always name an alternate, and talk to both people before signing so the appointment never comes as a surprise.
Medical power of attorney vs. living will
The two documents answer different questions. A medical power of attorney names WHO decides; a living will states WHAT you want for end-of-life treatment. They work best together: the living will covers the situations you anticipated, and your agent covers everything you did not. Many states bundle both into a single advance health care directive form.
| Medical power of attorney | Living will | |
|---|---|---|
| Names a decision maker | Yes | No |
| States treatment wishes | Optional guidance | Yes, in detail |
| Covers unforeseen situations | Yes, agent decides | No |
| Limited to end-of-life care | No | Usually yes |
Witnesses, notarization, and where to keep it
Execution rules vary more for medical powers of attorney than for almost any other document. Most states require two adult witnesses, some accept a notary instead, and a few (such as North Carolina) require both. Witness disqualifications are strict: your agent, your providers, and often relatives or heirs cannot witness. After signing, give copies to your agent, your alternate, your primary physician, and any hospital where you receive care, and keep a copy with your other estate documents. A copy is generally as effective as the original.
This document covers medical decisions only
A medical power of attorney gives no authority over your money or property. For finances, use a separate durable power of attorney.
Your agent decides only when you cannot: a living will states your end-of-life wishes directly, and an advance healthcare directive combines both documents in one. For financial matters, you need a separate durable power of attorney.
Frequently asked questions
When does my agent's authority start?
Only when your attending physician determines you lack the capacity to make or communicate your own decisions. While you are capable, you keep full control, and your agent has no authority.
Can my agent overrule my stated wishes?
No. Your agent is legally bound to follow the wishes you expressed, in this document or otherwise. Discretion applies only to situations your instructions do not cover.
Is a medical power of attorney valid in another state?
Generally yes: most states honor documents validly executed under another state's law. If you split time between two states, consider executing a document that satisfies both states' witness rules.
Can my spouse automatically make medical decisions without this document?
Often, but not reliably. State surrogate laws usually put a spouse first, but they vary, some situations are excluded, and family disagreements can force a guardianship case. Naming your agent removes the uncertainty.
How do I revoke or change a medical power of attorney?
You can revoke at any time while competent, orally or in writing, by notifying your agent or provider. To change agents, sign a new document: the most recent one controls. Then replace every copy in circulation.
Medical Power of Attorney rules in all 50 states
The table below summarizes the verified state rules with their statutory citations. Click your state for the full local guide; where a cell says "see statute", the rule is either not uniform or not compressed into a single number, and the state page explains what to check.
| State | Notarization | Witnesses | Statute |
|---|---|---|---|
| Alabama | Not required | two witnesses | Ala. Code 22-8A-4 |
| Alaska | Notary or two witnesses | two witnesses (alternative) | Alaska Stat. 13.52.010 |
| Arizona | Notary or one witness | one witness (alternative) | Ariz. Rev. Stat. 36-3221 |
| Arkansas | See statute | See statute | See statute |
| California | Notary or two witnesses | two witnesses (alternative) | Cal. Prob. Code 4673 |
| Colorado | Not required | None | Colo. Rev. Stat. 15-14-506 |
| Connecticut | Not required | two witnesses | Conn. Gen. Stat. 19a-576 |
| Delaware | Not required | two witnesses | Del. Code tit. 16, 2503 |
| District of Columbia | Not required | two witnesses | D.C. Code 21-2205 |
| Florida | Not required | two witnesses | Fla. Stat. 765.202 |
| Georgia | Not required | two witnesses | Ga. Code Ann. 31-32-5 |
| Hawaii | Notary or two witnesses | two witnesses (alternative) | Haw. Rev. Stat. 327E-3 |
| Idaho | See statute | See statute | See statute |
| Illinois | Not required | one witness | 755 Ill. Comp. Stat. 45/4-10 |
| Indiana | Not required | one witness | Ind. Code 16-36-1-7 |
| Iowa | Notary or two witnesses | two witnesses (alternative) | Iowa Code 144B.3 |
| Kansas | Notary or two witnesses | two witnesses (alternative) | Kan. Stat. Ann. 58-629 |
| Kentucky | Notary or two witnesses | two witnesses (alternative) | Ky. Rev. Stat. 311.625 |
| Louisiana | See statute | See statute | See statute |
| Maine | Not required | two witnesses | Me. Stat. tit. 18-C, 5-803 |
| Maryland | Not required | two witnesses | Md. Code, Health-Gen. 5-602 |
| Massachusetts | Not required | two witnesses | Mass. Gen. Laws ch. 201D, 2 |
| Michigan | Not required | two witnesses | Mich. Comp. Laws 700.5506 |
| Minnesota | Notary or two witnesses | two witnesses (alternative) | Minn. Stat. 145C.03 |
| Mississippi | Notary or two witnesses | two witnesses (alternative) | Miss. Code Ann. 41-41-205 |
| Missouri | See statute | See statute | Mo. Rev. Stat. 404.800 et seq. |
| Montana | See statute | See statute | See statute |
| Nebraska | Notary or two witnesses | two witnesses (alternative) | Neb. Rev. Stat. 30-3404 |
| Nevada | Notary or two witnesses | two witnesses (alternative) | Nev. Rev. Stat. 162A.790 |
| New Hampshire | Notary or two witnesses | two witnesses (alternative) | N.H. Rev. Stat. Ann. 137-J:14 |
| New Jersey | Notary or two witnesses | two witnesses (alternative) | N.J. Stat. Ann. 26:2H-56 |
| New Mexico | Not required | None | N.M. Stat. Ann. 24-7A-4 |
| New York | Not required | two witnesses | N.Y. Pub. Health Law 2981 |
| North Carolina | Required | two witnesses | N.C. Gen. Stat. 32A-16(3) |
| North Dakota | Notary or two witnesses | two witnesses (alternative) | N.D. Cent. Code 23-06.5-05 |
| Ohio | Notary or two witnesses | two witnesses (alternative) | Ohio Rev. Code 1337.12 |
| Oklahoma | Not required | two witnesses | Okla. Stat. tit. 63, 3101.4 |
| Oregon | Notary or two witnesses | two witnesses (alternative) | Or. Rev. Stat. 127.515 |
| Pennsylvania | Not required | two witnesses | 20 Pa. Cons. Stat. 5452 |
| Rhode Island | Notary or two witnesses | two witnesses (alternative) | R.I. Gen. Laws 23-4.10-2 |
| South Carolina | Not required | two witnesses | S.C. Code Ann. 62-5-504 |
| South Dakota | See statute | See statute | See statute |
| Tennessee | Notary or two witnesses | two witnesses (alternative) | Tenn. Code Ann. 68-11-1803 |
| Texas | Notary or two witnesses | two witnesses (alternative) | Tex. Health & Safety Code 166.154 |
| Utah | Not required | one witness | Utah Code 75-2a-107 |
| Vermont | Not required | two witnesses | Vt. Stat. tit. 18, 9703 |
| Virginia | Not required | two witnesses | Va. Code 54.1-2983 |
| Washington | Notary or two witnesses | two witnesses (alternative) | Wash. Rev. Code 11.125.050 |
| West Virginia | Required | two witnesses | W. Va. Code 16-30-4 |
| Wisconsin | Not required | two witnesses | Wis. Stat. 155.10 |
| Wyoming | Notary or two witnesses | two witnesses (alternative) | Wyo. Stat. 35-22-403 |