To get a medical power of attorney, choose a trusted person to act as your healthcare agent, fill out a form that meets your state’s requirements, sign it in front of witnesses or a notary, and give copies to your agent and your doctors. The document only takes effect if a physician determines you cannot make your own medical decisions, so you keep full control of your care for as long as you can speak for yourself. The steps below walk through each decision in order.
Step 1: Choose Your Healthcare Agent
Your healthcare agent is the person who will speak for you with doctors, nurses, and hospital staff. Pick someone who understands your values, religious beliefs, and treatment preferences, and who can make hard decisions under pressure. Medical training is not required. Willingness to advocate for your wishes, even when other family members push back, matters far more.
Who Can Serve
State laws set eligibility rules. The 2023 Uniform Health-Care Decisions Act, which several states have adopted and many use as a model, limits the role to adults or emancipated minors and bars certain people. Common disqualifications include owners, operators, and employees of a nursing home or long-term care facility where you live, unless they are a family member, and anyone subject to a protective order against you.1North Carolina General Assembly. Uniform Health-Care Decisions Act (2023) Your state may add restrictions, so check local rules before finalizing your choice.
Name at Least One Backup
Always name a successor agent in case your first choice is unavailable, unwilling, or unable to serve when the time comes. A successor cannot act until every agent ahead of them has resigned, died, become incapacitated, or declined. That chain keeps a single, clear line of authority and prevents confusion among medical staff. Naming a second backup is fine too. For each person on your list, primary and successor, you will need the full legal name, current address, and phone number.2American Bar Association. A Power of Attorney for My Health Care
Think Twice About Co-Agents
Some states allow you to name two agents to act at the same time. Unless you specifically require them to agree on every decision, each co-agent can typically act independently, which risks conflicting instructions reaching your medical team. If one co-agent learns the other is violating their duties, that co-agent has a legal obligation to intervene. For most people, one primary agent plus one or two successors is simpler and avoids the problem.
Step 2: Decide What Your Agent Can and Cannot Do
Your medical power of attorney can be broad or narrow. Without specific limits, most state forms give your agent authority to make any healthcare decision you could make yourself. If you want to restrict or expand that default, spell it out before completing the form.
Life-Sustaining Treatment
Decide in advance whether your agent can consent to or refuse treatments that keep you alive when recovery is unlikely. These decisions commonly involve cardiopulmonary resuscitation, mechanical ventilation, and artificial nutrition and hydration. Writing those instructions directly into the form, or into a separate living will, spares your agent from guessing and reduces the chance of family disputes.
Organ Donation and Mental Health Care
Include instructions on organ donation if you have strong feelings about it. If you want to address mental health treatments, such as whether your agent can authorize psychotropic medications or admission to a psychiatric facility, state those preferences clearly. Some states use a separate form for mental health advance directives with additional signing requirements, so check whether your state handles mental health authority differently.
HIPAA Access to Your Records
Federal privacy rules under HIPAA treat your healthcare agent as your “personal representative,” meaning hospitals and doctors must give your agent the same access to your protected health information that you have yourself.3U.S. Department of Health and Human Services. Personal Representatives Many state forms already include HIPAA release language. If yours does not, add a sentence that explicitly authorizes your agent to access your medical records. That prevents delays if a hospital’s legal department questions whether your agent can review your charts.
Step 3: Get the Right Form for Your State
Every state has its own rules for what a valid medical power of attorney must contain, so you need a form that complies with the law in your state of residence. Free, state-specific forms are available through your state’s bar association, department of health website, hospital system, or nonprofits focused on advance care planning. The American Bar Association also publishes a multi-state healthcare power of attorney form designed to be accepted broadly.2American Bar Association. A Power of Attorney for My Health Care
Fill in your identifying information and the contact details for each agent. Check or complete the sections that define your agent’s authority, marking any limitations or instructions you decided on in Step 2. Use plain, direct language in any write-in sections so a doctor reading the document during an emergency can understand your wishes quickly.
Step 4: Sign the Document Correctly
A completed form has no legal force until you sign it following your state’s execution requirements. You must sign while you still have the mental capacity to understand what you are doing, meaning you understand that you are giving another person authority over your medical care.
Witnesses and Notarization
Most states require you to sign in front of two adult witnesses. Some states allow notarization instead, and a few require both witnesses and a notary. Witness rules typically disqualify your healthcare agent, your treating physician, and employees of any facility where you are receiving care. In many states, at least one witness cannot be related to you by blood, marriage, or adoption and cannot be someone who would inherit from your estate.
If you use a notary, expect to pay a small fee. Statutory maximums for a notary acknowledgment range from about $2 to $25 depending on the state, with most falling in the $5 to $15 range. Some states set no maximum, so the notary sets their own price.
Remote Online Notarization
Most states now permit remote online notarization, where a notary verifies your identity and witnesses your signature through a live audio-video connection. That option helps if you are homebound, hospitalized, or living far from a notary’s office. Not every state accepts remote notarization for healthcare documents specifically, so confirm your state’s rules before relying on it.
Extra Rules for Nursing Home Residents
If you live in a nursing home or long-term care facility, several states impose additional signing requirements. California, Delaware, the District of Columbia, South Carolina, and Vermont, among others, require that a patient advocate or state-designated ombudsman witness the document or explain it to you before you sign. Ask your facility’s social worker or patient advocate whether your state has this requirement. Skipping it could make the document unenforceable.
Step 5: Distribute and Store Copies
After signing, keep the original where you can reach it quickly, such as a desk drawer or home filing cabinet. Avoid storing it in a bank safe deposit box, which may be locked outside of business hours when you need the document most. Tell your family where the original is kept.
Give copies to:
- Your healthcare agent and each successor agent, so they can present it to medical staff when acting on your behalf.
- Your primary care physician, and ask the office to scan it into your electronic medical record so it is accessible across the health system.
- Any specialists you see regularly, especially if you have a chronic condition that could lead to hospitalization.
- Close family members who are not your agent but who could help locate the document in an emergency.
Emergency Access
Consider carrying a wallet card behind your driver’s license that notes you have a medical power of attorney and lists your agent’s name and phone number. Some hospitals and organizations provide printable wallet-sized cards for this purpose. A growing number of states also maintain electronic advance directive registries where you can upload your document so that emergency responders and hospitals can access it remotely. Check whether your state offers a registry and whether registration is free.
Keeping the Document Current
You can revoke your medical power of attorney at any time, for any reason, as long as you have the mental capacity to do so. Under the Uniform Health-Care Decisions Act, revocation can happen through any act that clearly shows you intend to cancel the document, including an oral statement to a healthcare professional, a written revocation, or the physical destruction of the document.1North Carolina General Assembly. Uniform Health-Care Decisions Act (2023) Oral revocation is valid in many states, but putting the revocation in writing and notifying your agent and doctors in writing provides the clearest proof.
To change your agent rather than cancel the document entirely, the simplest approach is to create a new medical power of attorney. Include a sentence in the new document stating that it revokes all prior healthcare powers of attorney. Distribute the new version to everyone who received the old one and ask them to destroy prior copies.
Divorce
If you named your spouse as your healthcare agent and later file for divorce, many states automatically revoke that appointment. The Uniform Health-Care Decisions Act treats the filing of a divorce petition as automatic revocation of a spouse’s appointment unless the document says otherwise.1North Carolina General Assembly. Uniform Health-Care Decisions Act (2023) Not every state follows this rule, so signing a new medical power of attorney with a different agent after a divorce or separation is the safest course.
Moving or Traveling Between States
Most states have provisions that recognize out-of-state advance directives, typically honoring a document if it was valid in the state where it was signed or if it meets the requirements of the state where you are receiving treatment. Outright refusals are rare. The bigger risk is that specific terms may be read differently under another state’s law. For example, one state may define “life-sustaining treatment” more narrowly than another. If you spend significant time in two states, consider having an attorney review whether your document satisfies both, or sign a second form for the other state.
What Happens If You Do Nothing
Without a medical power of attorney, doctors turn to your state’s default surrogate hierarchy to identify who can make decisions for you. The typical priority runs from a spouse or domestic partner to an adult child, a parent, an adult sibling, and then more distant relatives. The specific order and who qualifies vary by state.
That default has two weak points. It may not reflect your actual wishes, since you might trust a close friend or a particular sibling more than the person at the top of the legal list. And if family members disagree about your care, the hospital may need to seek a court-appointed guardian, which brings delays and legal costs during a medical crisis. Completing the steps above puts a person you chose in charge from the start.