This form provides for partial or total revocation of the Health Care Proxy provided for in Form MA-P020. See General Laws of Massachusetts, Chapter 210D, Section 7.
Massachusetts Revocation of Health Care Proxy
State:
Massachusetts
Control #:
MA-P020B
Format:
Word;
Rich Text
Instant download
Description
How to fill out Massachusetts Revocation Of Health Care Proxy?
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FAQ
Under the Health Care Proxy Law (Massachusetts General Laws, Chapter 201D), any competent adult 18 years of age or over may use this form to appoint a Health Care Agent.
To resign, you can simply write up a document titled "Resignation" saying "I hereby resign as Agent under the Medical Power...
A principal may revoke a health care proxy by notifying the agent or a health care provider orally or in writing or by any other act evidencing a specific intent to revoke the proxy.
All competent adults, 18 years of age or older, can appoint a health care agent by signing a form called a Health Care Proxy. You don't need a lawyer or a notary, just two adult witnesses. Your agent cannot sign as a witness. You can use the form printed here, but you don't have to use this form.
Additionally, it is important to know that you may change your proxy at any time. To do so, create a new health care proxy document. If you regain the ability to make your own decisions, you can choose to speak on your own behalf again.
Can a nurse practitioner make the written determination of incapacity to activate a Health Care Proxy? No.
The primary care doctor invokes the proxy by writing in the chart The Healthcare Proxy is invoked. If hospitalized, the medical team can invoke the proxy in the same way, ONLY if the patient is unconscious or clearly has dementia. The courts can invoke a healthcare proxy.
There is no formal procedure for retiring as someone's health care proxy. You simply decline to accept the responsibility when the time comes.
A health care proxy designates an individual, often a family member, to legally make medical decisions for another. It can only be activated when a doctor declares the person incompetent.
