A Medical Durable Power of Attorney (MDPOA) is a legal document appointing your Health Care Agent (agent) who can make medical decisions for you in the event you have become incapacitated and are unable to speak for yourself. You can also include alternate agents in the event that the primary agent is unavailable to act. Before appointing someone as your agent make sure you speak to them and they agree to take on this responsibility.
Because everyone 18 years old or older is responsible for their own medical decisions, each person over 18 should have a MDPOA completed. Choosing a Health Care Agent is critical.
Your agent should be someone:
- of trust,
- who is willing to learn about and understand your health conditions,
- who will follow your wishes, not their own,
- can work with a team,
- can be available in an emergency, and
- who will continue to be available to make ongoing decisions for care.
Unlike the Living Will, a MDPOA is not limited to end-of-life and can be used any time a person becomes incapacitated and is unable to speak for themselves. The agent has decision-making duties about where they may place you if there is need to be in a facility for rehabilitation, decisions about medical care, housing or placement for care as well as transportation among other things. Individuals who cannot give consent cannot have a MDPOA, and must instead use a medical health care proxy or court-appointed guardianship.
A major best practice is to have your MDPOA notarized. Once your MDPOA is completed, you need to provide copies to:
- your agent and alternates,
- all of your medical professionals that keep medical records on you, and
- any hospital, assisted living facility, nursing home, or other medical facility when admitted.
Agent and Alternate Agent's
Mailing or Residential Address
Phone Number(s) and/or Email Address(es)
Before you complete the form, discuss with the person(s) you are considering as your agent and alternates. Your agent and alternate need to be:
18 years or older
Willing to accept the responsibility
Available in case of an emergency
Available in case you need ongoing care
Get the form notarized by a notary public. Usually your bank will offer free notary services.
You must sign the form in front of the notary public. Do not sign the form until you are in the notary's presence.
Who to Notify
Give Copies of Form to:
Alternate agents, if any