An Illinois medical power of attorney is a written document in which you, the principal, name an agent to make health care decisions for you. It is also called a health care POA. Illinois requires a witness to sign it, and the FormsPal template lets you fill it out online or download it as a PDF.
Last Updated: October 2026. This guide is reviewed and updated regularly to reflect current Illinois law. If you notice an error or outdated information, please contact us.
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Looking for other documents? See all Illinois power of attorney templates, with instructions for each.
The principal, who is the person making the document, must sign it, and a witness must also sign it before it is valid.[2] The document must carry the signature of a witness to the signing, and the statute limits who can serve as that witness.[1]
every health care agency shall bear the signature of a witness to the signing of the agency.
Illinois law sets out a statutory short form for a health care power of attorney in 755 ILCS 45/4-10. The statutory form is not intended to be exclusive, so you do not have to use it.[2] If you do use the statutory short form, it authorizes your agent to direct that an autopsy be made, to make a disposition of any part or all of your body under the Illinois Anatomical Gift Act, and to direct the disposition of your remains.[2]
If you become unable to make your own health care decisions and have not named an agent in writing, the notice in the statutory short form explains that your physician and other health care providers will ask a family member, friend, or guardian to make decisions for you. The notice adds that in Illinois, a law directs which of these individuals will be consulted.[2]
Illinois bars several groups from acting as a witness. A witness cannot be any of the following:[1]
In addition, no witness may be under 18 years of age.[1]
| Document Name | Illinois Medical Power of Attorney Form |
| Also Called | Illinois Power of Attorney for Health Care |
| State Laws | Illinois Compiled Statutes, Chapter 755, Section 45, Article 4 |
| Signing Requirements | Signature of the principal and signature of a witness[2][1] |
| Who Can’t Be the Witness? | See the list above, from 755 ILCS 45/4-5.1[1] |
| Avg. Time to Fill Out | 8 minutes |
| # of Fillable Fields | 25 |
| Available Formats | Adobe PDF |
Your agent is the person you name in the document to make health care decisions on your behalf. Naming one is a choice about trust, so talk it through before you write a name on the form. The questions below are common practice, not legal requirements, and they help your agent act on your wishes when medical decisions come up.
For a general explanation of the document, read our guide to the medical power of attorney form. For other kinds of authority, see our Illinois durable power of attorney page.
Popular Local Medical POA Forms
Medical power of attorney forms enable you to establish an agent who can take care of your health affairs after you get incapacitated. Below are the states MPOA forms are requested in most regularly.
The FormsPal template for Illinois is titled Medical Power of Attorney with Advance Directive. It has three numbered parts, plus a notary acknowledgment and a witness block. What each part says comes from the printed text of the form, not from Illinois law, so read all of it before you sign.
If Part II does not match your wishes, talk to a lawyer or your doctor before you sign. You can also compare it with our Illinois living will form.
The template has 25 fillable fields, and the six steps below follow it from page 1 to page 9. Page 8 holds a General Information notice, so read it before you start. Each step names the part of the form it covers and shows sample entries so you can see where each answer goes.
The screenshots under each step show the FormsPal Illinois medical power of attorney template filled with sample entries in blue, so you can see where each answer goes. The names, addresses, dates and amounts are examples only.
Illinois requires a witness signature on a health care power of attorney, and the statute limits who can serve as a witness. Each answer below cites the statute at its end, so you can check the wording yourself before you sign.
Yes. You must sign the form, and a witness must also sign it before it is valid.[2] The document must carry the signature of a witness to the signing.[1]
The law lists who cannot witness, so check it before you choose. A witness cannot be any of these:
The statute also bars relatives of those professionals and of the facility owner or operator.[1]
A witness must be at least 18 years old, because no witness may be under 18 years of age.[1]
The bar on the operator of a health care facility extends to the directors and executive officers of an operator that is a corporate entity. It does not extend to other employees of the operator, such as non-owner chaplains, social workers and nurses.[1]
Other Medical POA Forms by State
You can download this health care power of attorney as a PDF with 25 fillable fields, or build it online and print it. If you download the PDF, you can fill in the PDF on screen before you print it. Either way, you must sign the document and a witness must also sign it before it is valid.[2]
General information, not legal or tax advice.
Unless noted otherwise, the sources below are from the Illinois Compiled Statutes.
