New York Medical Power of Attorney (POA) Form

The‌ New York Health Care Proxy (Medical POA) Form is recommended for all adult citizens, regardless of their health status, in case of an unforeseen incident. The New York Health Care Proxy (Medical POA) Form is a special kind of document created by the principal if the principal is unable to make decisions about his or her health care. In the New York medical power of attorney form, a principal refers to an individual who will be an attorney, making health care decisions instead of a principal. The attorney will be able to use his powers if the state of the principal does not allow him to do this on his own. The recognition of the principal as incompetent is possible for several reasons: as a result of an accident that resulted in serious injuries, general anesthesia, coma, serious illness.

The New York Health Care Proxy (Medical POA) Form must be signed with two witnesses for the document to be considered valid in the state. We advise you to choose an individual as an attorney to whom the principal fully entrusts his health care issues. At the same time, as an attorney, it is worth choosing a person who is not an heir of the principal so that this does not affect his decisions regarding the principal’s healthcare. ‌

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New York Laws and Requirements

According to Article 29-C – 2980(8) definition, The New York Health Care Proxy (Medical POA) Form must be signed in the presence of two witnesses, 18 years of age or older. Upon signature of The New York Health Care Proxy (Medical POA) Form. This type of document does not need to be notarized for it to be valid on the territory of the state of New Jersey.  The New York Health Care Proxy (Medical POA) Form is recommended for every adult citizen, regardless of health status. The attorney will have the power to take responsibility for making decrees concerning the principal’s healthcare, including the chance of an accident. The original version of the form should be kept by the attorney in a safe but easily accessible place.

Steps to Fill Out the Form

If you are already familiar with The New York Health Care Proxy (Medical POA) Form necessary aspects of making and are ready to start filling out a form, we advise that you familiarize yourself with the detailed step-by-step instructions below. Avoid possible mistakes and shortcomings.

  • Download the form

Download the form on our website to fill it out electronically or print it out and fill it out in. To ensure the best result, use our form building software. You can download the form in any format that suits you.

  • Indicate who is the principal and attorney

In the first part of the document, you need to identify the identities of the principal and the attorney. To do this, in the first part, you need to enter your (principal) full legal name and contact information (place of residence, email, and contact phone number). After that, you need to enter the full legal name of the attorney and his contact information (place of residence, email, and contact phone number).
Principal and attorney indication part of New York mpoa template

  • Indicate optional solutions 

After you identify the principal and attorney, you need to appoint an alternate attorney in case the first attorney is unable to make health decisions for the principal. You also need to determine the date from which the attorney will be eligible to use their authority. If you want the attorney to have the credentials to use their powers from the moment of signing the form, you need to identify this in this part. If you want the attorney to have the credentials to use their authority only if you are found incapacitated, you must also identify this in this part.
Optional solutions indication section of a medical power of attorney for New York

  • Limit the powers of an attorney

In this section of the document, you can limit the powers of the attorney if you have such a need. Even if you have previously discussed with the attorney the procedure for conducting healthcare procedures in certain cases, it is better to repeat and list all your wishes and limit the attorney’s powers in this section of the document.
Powers limitation section of a New York medical power of attorney form

  • Indicate your wishes regarding organ donation

Here you need to indicate whether you are ready to donate organs after your death. If you are ready to donate any organs, you need to put your initials in front of this statement. If you are ready to donate some organs, you need to list all the organs that you are ready to donate. If you have special instructions regarding the donation of your organs after death, you need to check all the special instructions and instructions in the column specially allocated for this.
Part for wishes regarding organ donation of mpoa document for New York

  • Sign the form

If you agree with all the affirmations and parts of this form, you need to enter your full legal name, address, contact phone number, and email. The attorney and witness must also fill in their full legal names and contact info and put the signatures.
Signing part of New York medical power of attorney form

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Published: Nov 19, 2020