FREE FILLABLE PDF

Free medical power of attorney form

Name someone to make health-care decisions if you cannot speak for yourself. Free fillable PDF.

This PDF is in English.

What's on this form

Medical power of attorney

Name someone to make health-care decisions if you cannot speak for yourself.

  • Health-care agent and optional alternate
  • Authority to talk with doctors and see records
  • Optional limits and a living-will reminder
  • Witness and notary blocks

Use it this way

Fill, print, sign, store

Type in the PDF fields or print a blank copy. Sign only the way your state requires. Keep the original. Upload a copy to your vault so family can find it.

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Get the form reviewed. Then store it.

Find an estate planning attorney near you. Keep the signed original. Put a copy in your vault.