According to the law of the USA, all individuals 18 years of age may initiate creation of a Medical Power of Attorney. This document is also known as “Advance Directive,” and it serves as legal evidence that a person (the principal) has designated an agent to act on the principal’s behalf if the latter experiences incapacitation and is not able to make decisions upon health care treatment.
The medical power of attorney form in each state is regulated by specific local laws. Thus it is recommended to study all the necessary MPOA-related information prior to initiating its completion.
In North Carolina, the MPOA has to be witnessed by two adults and notarized.
North Carolina power of attorney forms – download more power of attorney forms for North Carolina together with instructions.
Ensure you are appointing an agent the trustworthy person you are familiar with, and believe him or her to act in your interest once you might experience incapacitation, disability, coma, or vegetative state. The document will provide your attorney with broad powers, including but not limited by withholding or withdrawal life-prolonging procedures.
You may wish to initiate revocation of the MPOA at any time if you are sound of mind and able to sign a new paper or tell your attending physician about your decision. If you have not revoked the paper, it will be considered effective until the moment of death.
| Document Name | North Carolina Medical Power of Attorney Form |
| State Form Name | North Carolina Health Care Power of Attorney |
| State Laws | North Carolina General Statutes, Chapter 32A, Article 3 |
| Signing Requirements | Notary Public AND Two Witnesses |
| Who Can’t Be the Agent? | Section 32A-18 |
| Who Can’t Be the Witness? | Section 32A-16(6) |
| Avg. Time to Fill Out | 8 minutes |
| # of Fillable Fields | 21 |
| Available Formats | Adobe PDF |
Popular Local Medical POA Forms
MPOA documents are frequently in pretty much every state. Check out other sample MPOA forms regularly filled out by the US citizens.
To successfully complete the paper, follow the set of step-by-step instructions below:
Once you have decided to create the Medical Power of Attorney, download the form from any reliable source page, or use our form building software.
The principal is supposed to provide his or her full name, being sound of mind and willing to grant the medical powers to a chosen attorney-in-fact. Then enter the name, address, home, work, and cellular phones of the agent. If you wish, you may designate two alternative attorneys meant to perform their duties in case the original agent is unable or unwilling to do so.
The attorney is supposed to become effective the moment one or two physicians you list in this section determine a lack of capacity to make decisions related to your health care. If the physician(s) are not found available, the determination should be stated by an attending physician.
The next section describes the set of powers you grant your agent, including artificial nutrition or hydration, limitations concerning health care decisions, mental health treatment, autopsy, and disposition of remains. If you wish to limit the scope of powers, you may enter specific preferences in the blocks and initial the corresponding boxes. If you do not submit special limitations and leave the boxes not initialed, your health care agent will be authorized to make any decisions you could make to obtain or terminate health care treatment.
If you intend to donate the body or body parts, enter the limitations you consider appropriate and initial the corresponding boxes.
After you have studied all the information provided in the MPOA and filled out additional instructions (limitations), insert the date and affix the signature.
Two adult witnesses, being first duly sworn, have to sign their full names, stating that the principal has completed the form sound of mind and under no influence. Input the date, county, and state where the MPOA is being created.
A licensed notary should type or print the names of both witnesses and the principal, insert the date, provide credentials, commission expiration date, and the county.
Other Medical POA Forms by State
