Medical Power of Attorney Form for Missouri Open This Medical Power of Attorney Now

Medical Power of Attorney Form for Missouri

The Missouri Medical Power of Attorney form allows individuals to designate a trusted person to make healthcare decisions on their behalf when they are unable to do so. This legal document ensures that your medical preferences are honored, even if you cannot communicate them. To take control of your healthcare decisions, consider filling out the form by clicking the button below.

Open This Medical Power of Attorney Now
Article Guide

In the realm of healthcare decision-making, the Missouri Medical Power of Attorney form serves as a crucial tool for individuals seeking to ensure their medical preferences are honored when they are unable to communicate their wishes. This form allows a person, often referred to as the principal, to designate a trusted individual, known as the agent, to make medical decisions on their behalf. The form encompasses various aspects, including the authority granted to the agent, the types of medical treatments that can be accepted or declined, and any specific wishes regarding end-of-life care. By completing this document, individuals can articulate their values and desires regarding healthcare, thus alleviating the burden on family members during challenging times. Importantly, the Missouri Medical Power of Attorney is not just a one-size-fits-all document; it allows for customization based on personal beliefs and circumstances. Moreover, understanding the implications of this form can empower individuals to take control of their healthcare decisions, fostering a sense of peace and assurance that their choices will be respected. With the right knowledge and preparation, anyone can navigate the complexities of medical decision-making, ensuring their voice remains heard even in the most trying situations.

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Missouri Medical Power of Attorney

This Missouri Medical Power of Attorney is a legal document that allows an individual (the "Principal") to designate another person (the "Agent") to make health care decisions on their behalf should they become unable to do so. This document is made pursuant to the Missouri Durable Power of Attorney for Health Care Act.

Principal Information

Full Name: _____________________________

Address: ______________________________

City: _____________________ State: MO Zip Code: _________

Phone Number: _________________________

Agent Information

Full Name: _____________________________

Relationship to Principal: _______________

Address: ______________________________

City: _____________________ State: MO Zip Code: _________

Phone Number: _________________________

Alternate Phone Number: ________________

Alternate Agent Information (Optional)

Full Name: _____________________________

Relationship to Principal: _______________

Address: ______________________________

City: _____________________ State: MO Zip Code: _________

Phone Number: _________________________

Alternate Phone Number: ________________

General Statement of Authority Granted

When the Principal is unable to make or communicate health care decisions, the Agent named above is authorized to make medical and health care decisions on behalf of the Principal. This includes decisions regarding the withholding or withdrawal of life-sustaining treatment and the power to approve or disapprove medical procedures, services, or interventions.

Special Instructions

Please list any specific limitations you wish to place on the Agent's authority, specific treatments you do or do not want, or any other special instructions:

________________________________________________________________

________________________________________________________________

Duration

This Medical Power of Attorney remains in effect until the Principal's death, unless the Principal revokes it in writing or specifies a different date or condition for its termination.

Signature

By signing below, the Principal acknowledges that they have read and understand the contents of this document and affirm this as their act and deed. This Medical Power of Attorney must be signed in the presence of two witnesses or a notary public.

Principal's Signature: ___________________________ Date: ____________

Witness 1 Signature: ____________________________ Date: ____________

Witness 2 Signature: ____________________________ Date: ____________

Notarization (If applicable)

This section should be completed by a notary public if the Principal wishes to notarize this document.

State of Missouri )

County of ___________ )

Subscribed and sworn before me this _____ day of ___________, 20___

Notary Public Signature: ___________________________________

My commission expires: _____________________________________

Form Details

Fact Name Description
Definition A Missouri Medical Power of Attorney allows an individual to designate someone to make healthcare decisions on their behalf if they become incapacitated.
Governing Law This form is governed by the Missouri Revised Statutes, specifically Chapter 404, which covers durable powers of attorney.
Eligibility Any adult resident of Missouri can create a Medical Power of Attorney, as long as they are of sound mind.
Agent Requirements The appointed agent must be at least 18 years old and cannot be the healthcare provider or an employee of the healthcare provider unless they are a relative.
Signature Requirements The form must be signed by the principal (the person granting authority) and witnessed by two individuals or notarized.
Revocation The principal can revoke the Medical Power of Attorney at any time, as long as they are competent to do so.
Healthcare Decisions The agent can make a wide range of healthcare decisions, including consent to or refusal of medical treatment, based on the principal's wishes.
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