Medical Power of Attorney (Healthcare Proxy)
A medical power of attorney, also called a healthcare proxy, is a legal document in which a principal appoints a healthcare agent to make medical treatment decisions on the principal's behalf if the principal becomes unable to make or communicate those decisions personally. Use this when someone wants to name a specific person to make healthcare decisions on their behalf if they become incapacitated, rather than only stating their own treatment wishes as in a living will — the two documents work well together, with the living will guiding the agent named here. This authority is limited to healthcare decisions and does not cover financial or legal matters. Many states have specific witnessing, notarization, or statutory-form requirements for healthcare proxies, so confirm and complete the formalities that apply where the Principal lives before relying on this document.
What's included
A ready-to-use medical power of attorney (healthcare proxy) with signature fields already placed for Principal and Agent. Fill in the bracketed details (like [Company Name] or [Date]) using Docracy's built-in text editor, then send it out for signature.
This is a general template for informational purposes only and does not constitute legal advice. Consult a qualified attorney to review it for your specific situation and jurisdiction before use.
Key clauses
- Appointment of healthcare agent and alternate agent
- Scope of medical decision-making authority granted
- Conditions triggering the agent's authority, such as an incapacity determination
- Guidance or limitations on treatment decisions
- Coordination with any living will or advance directive
- Witnessing and/or notarization clause
What you'll fill in
[Principal's Full Name][Healthcare Agent Name][Alternate Healthcare Agent Name][Effective Date][Scope of Medical Decisions Authorized][Incapacity Determination Method][Witness Name(s)]Legal summary
Signing a medical power of attorney legally authorizes the named healthcare agent to make medical treatment decisions for the principal once the principal is unable to make or communicate those decisions personally. Its authority is limited to healthcare matters and does not extend to financial or legal affairs. Many places require specific witnessing, notarization, or statutory forms for a healthcare proxy to be honored by medical providers, so those requirements where the principal lives need to be confirmed and completed separately.
Free for up to 2 signers, no account required. Need unlimited? Flat $10/month.
FAQ
Is this Medical Power of Attorney (Healthcare Proxy) legally binding?
Signing through Docracy uses a simple electronic signature (SES), which is legally recognized for everyday business agreements under laws like the U.S. ESIGN Act and the EU's eIDAS regulation. This is a general template, not legal advice — for high-stakes or regulated agreements, have a qualified attorney review it for your situation.
Who needs to sign this Medical Power of Attorney (Healthcare Proxy)?
This template includes signature fields for Principal and Agent — already placed, so you just fill in the details and send.
Can I edit this Medical Power of Attorney (Healthcare Proxy) before sending it?
Yes — Docracy's editor lets you edit the text, add or remove signature fields, redact sections, and reorder pages before you send it.
Do I need an account to send this Medical Power of Attorney (Healthcare Proxy)?
No — it's free for up to 2 signers with no account required. Create a free account only if you want to save it to a dashboard or reuse it later.
Try it with an AI assistant
Paste one of these into ChatGPT, Claude, or your assistant of choice:
“Explain what a medical power of attorney lets my healthcare agent decide on my behalf.”
“How does a medical power of attorney work together with a living will?”
“What should I discuss with the person I'm naming as my healthcare agent before signing?”
Why teams start with Docracy
“Docracy is a great product that I have tested and am using. It is easy to use, has good tools, is always up to date, and implements new features. Highly recommended.”— DACH Advisory
Free for up to 2 signers, no account required. Need unlimited? Flat $10/month.