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Click ‘Get Form’ to open the hi attorney document in the editor.
Begin by filling in your name and address in the 'DESIGNATION OF HEALTH CARE AGENT' section. This identifies you as the principal.
Next, designate your health care agent by entering their name, address, and telephone number. This person will make health care decisions on your behalf.
In the 'STATEMENT OF DESIRES, SPECIAL PROVISIONS, AND LIMITATIONS' section, clearly outline any specific wishes regarding life-prolonging treatments or other health care preferences.
Review the 'INSPECTION AND DISCLOSURE OF INFORMATION' section to grant your agent access to your medical records. Specify any limitations if necessary.
Complete the 'DURATION' section if you wish to limit how long this power of attorney remains effective.
Finally, ensure that you sign and date the document in front of witnesses as required for it to be valid.

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