A South Carolina medical power of attorney is a written document in which you, the principal, name an agent to make health care decisions for you. State law calls it a health care power of attorney.[1] This free FormsPal template is a power of attorney form SC residents can fill out online. It takes effect only when your treating physician certifies in writing that you cannot make informed decisions, and Part II adds a printed advance directive.
Last Updated: October 2026. This guide is reviewed and updated regularly to reflect current South Carolina law. If you notice an error or outdated information, please contact us.
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Visit our South Carolina power of attorney templates for more South Carolina-specific power of attorney documents that you might require.
South Carolina's health care power of attorney statute, S.C. Code Ann. § 62-5-503, sets five legal requirements. The document must be dated, signed, witnessed, backed by witness declarations and substantially in the statutory form.[1]
The FormsPal template adds a printed advance directive in Part II to the power of attorney in Part I. One signed document then names your agent and states your end-of-life wishes. For a general explanation, see our medical power of attorney form guide.
Under section 62-5-503, a health care power of attorney must meet these requirements:
The witness rule in section 62-5-503 reads:
Be signed by at least two persons, each of whom witnessed either the signing of the health care power of attorney or the principal's acknowledgment of his signature on the health care power of attorney.
Choose your witnesses before you sign. Each witness has to declare that, to the extent the witness knows, the witness is not related to you by blood, marriage or adoption.[1] Page 6 of the template has a declaration and a signature block for each of two witnesses.
Section 62-5-503 also says that your health care agent must be an individual who is 18 years of age or older and of sound mind.[1] Your agent also may not be a health care provider, or an employee of a provider, with whom you have a provider-patient relationship when you sign the health care power of attorney. Nor may your agent be an employee of a nursing care facility in which you reside, or a spouse of the health care provider or employee, unless that provider, employee or spouse is your relative.[1]
Notarization is optional. The statutory form in section 62-5-504 marks its notary section as optional and not required to create a valid health care power of attorney.[1]
| Document Name | South Carolina Medical Power of Attorney Form |
| State Form Name | South Carolina Health Care Power of Attorney |
| State Laws | S.C. Code Ann. § 62-5-503[1] |
| Signing Requirements | Dated and signed by the principal, and signed by at least two witnesses[1] |
| Witness Declaration | Each witness states, to the extent of the witness's knowledge, that the witness is not related to the principal by blood, marriage or adoption[1] |
| Statutory Form | Substantially the form in section 62-5-504[1] |
| # of Fillable Fields | 32 |
| Form Pages | 6 |
| Available Formats | Adobe PDF |
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The FormsPal South Carolina medical power of attorney template has 32 fillable fields across six pages. You fill in your name and your agent's details on page 1 and the date and your signature on page 3. You also complete the notary acknowledgment on page 4 and the two witness blocks on page 6. Everything else is preprinted text.
The screenshots under each step show the FormsPal South Carolina 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.
Read Part II before you sign. It is printed text with no boxes to initial. It asks your health care providers to withhold or withdraw all treatments other than those needed to keep you comfortable.
Already have a living will? Part III of the template revokes prior powers of attorney for health care, living wills and directives to physicians. It does not revoke durable general powers of attorney for asset management.
To put your South Carolina medical power of attorney to use, print the form and sign it. Two witnesses must watch you sign or hear you acknowledge your signature.[1] After that, share copies with the people who will rely on it and keep the original where your agent can find it.
These answers come from section 62-5-503 of the South Carolina Code, which sets the legal rules for signing and witnessing a health care power of attorney, and from the FormsPal template itself.
At least two. Each of them must have witnessed either the signing of the health care power of attorney or the principal's acknowledgment of his signature on it.[1]
The statute restricts it. Each witness must state in a declaration that, to the extent the witness has knowledge, the witness is not related to the principal by blood, marriage or adoption. That covers a spouse, a lineal ancestor, a descendant of the parents of the principal, and the spouse of any of them.[1]
Yes. The document must be dated and signed by the principal.[1]
Only in one situation. The principal may sign, or another person may sign in the principal's name, in the principal's presence and by his direction.[1]
It must be substantially in the form set forth in section 62-5-504 of the South Carolina Code.[1]
Yes. Page 4 of the template has an acknowledgment block with the state, county, date, the notary's name, the notary's signature and the seal.
This free power of attorney form SC residents can print has 32 fillable fields across six pages. Fill it in with the form at the top of this page, then download and print it. The principal dates and signs the printed copy, and at least two witnesses sign it too.[1]
General information, not legal or tax advice.