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  • Montefiore Health Care Proxy Form

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Health Care Proxy Appointing Your Health Care Agent In New York State Please Note: This document is also available in Spanish. To order, call Patient/Health Education at (718) 920-6058. Policy Statement:.

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A health care proxy is a document that allows you to appoint another person(s) as your health care agent to make health care decisions on your behalf if you are no longer able to do so.

A Health Care Proxy designates another person to make medical decisions should you be unable to do so, and a Living Will allows you to list medical treatments that you would or would not want if you became terminally ill and unable to make your own decisions.

Generally, the cost is around $250 to $400.

Must be signed by two witnesses or notarized. Neither of your witnesses nor the notary may be your health care agent. ... If you choose to have the document notarized, the notary may not be your health care agent.

Your health care proxy can only make medical decisions for you. ... Depending on your state, decisions about health insurance and paying health care bills may be considered financial decisions. You do not need a lawyer to name a health care proxy, but there are organizations that can help you if you wish.

Choose someone you trust the most to: ... Print a Health Care Proxy form. ... Complete and sign the form. Ask two other people to sign the form as witnesses. Put the form where it is easy to find. Give a copy of your health care proxy form to your health care agent.

Healthcare Proxy and Power of Attorney Responsibilities A health care proxy has the authority to make medical decisions and a power of attorney has the authority to make financial decisions. So while a health care proxy may choose a senior living community, the power of attorney must release the funds to pay for it.

In the absence of a health care proxy, family members or the medical institution will have to go to court to have someone appointed as guardian and in extreme cases, get specific court authority for specific medical procedures. This process can be cumbersome, expensive, and time-consuming.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232