Get Health Care Proxy Wallet Card

The Health Care Proxy Wallet Card allows individuals to designate a Health Care Agent to make important health care decisions on their behalf in case they are unable to do so. This guide provides clear, step-by-step instructions for completing the form online, ensuring that your preferences are properly documented.

Follow the steps to complete your Health Care Proxy Wallet Card online.

1. Click the ‘Get Form’ button to access the Health Care Proxy Wallet Card and review it carefully.
2. Fill in your full name in the section designated for the Principal. This identifies you as the person designating the Health Care Agent.
3. Designate your Health Care Agent by entering their full name, along with any necessary contact information such as cell phone and alternate phone numbers.
4. Indicate the street address, city, and state of your Health Care Agent to ensure they can be reached in an emergency.
5. Optionally, specify any wishes regarding organ and/or tissue donation by checking the appropriate boxes and detailing the organs or tissues you wish to donate.
6. Provide any special instructions or limitations to your Agent's decision-making authority, ensuring these wishes are clear.
7. After completing the Wallet Card, sign it in front of two witnesses who are at least 18 years old and not designated as your Agent. They should also sign the document.
8. Store the completed card in your wallet alongside other important documents. Remember to share the Health Care Proxy Form with your medical providers.

Take action now and complete your Health Care Proxy Wallet Card online to ensure your health care preferences are respected.