Get Health Care Proxy Form

Filling out a Health Care Proxy Form online can ensure that your medical decisions are aligned with your values and wishes. This guide will lead you through each component of the form, making the process clear and accessible for all users.

Follow the steps to complete the Health Care Proxy Form online

1. Click ‘Get Form’ button to obtain the form and open it in your document editor.
2. Begin by entering your full name in the designated space. It is important to ensure this is accurate as it identifies you in the document.
3. Indicate your medical directives clearly. Specify if you wish to decline medical treatments under certain conditions such as terminal illness or permanent unconsciousness. You can also list specific treatments you do not want.
4. Complete the section regarding general grant of power and authority. This section allows you to appoint a health care agent who can make decisions on your behalf. Fill in their full name, address, and phone number.
5. Provide HIPAA release authority to your agent by affirming their ability to access and disclose your health information. This ensures your agent has the necessary authority to advocate for your health care.
6. Designate a substitute health care agent in case your primary agent is unavailable. Fill in their details in the specified section.
7. Sign the document in the designated area to give it legal authority. Include your address and the date of signing.
8. Arrange for two witnesses, who must be at least 18 years old, to sign the document and confirm your state of mind and free will. Provide their names, signatures, and addresses.
9. Once completed, review all sections to ensure accuracy. Save changes to the document and then download, print, or share the form as necessary.

Complete your Health Care Proxy Form online today to ensure your health decisions reflect your wishes.