Power of Attorney for Health Care - Statutory Form - Nebraska 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in your name and contact information at the top of the form. This identifies you as the principal granting power of attorney.
  3. Designate your primary attorney in fact by entering their name, address, and telephone number. This person will make health care decisions on your behalf if you are unable to do so.
  4. Optionally, appoint a successor attorney in fact by providing their details. This ensures continuity in decision-making if your primary choice is unavailable.
  5. Specify any instructions or limitations regarding health care decisions. This section allows you to express your wishes clearly.
  6. If desired, include specific directives about life-sustaining treatment and nutrition/hydration options. These are crucial for guiding your attorney's decisions.
  7. Sign and date the document at the bottom to validate it. Ensure that witnesses sign as well, confirming they observed you signing voluntarily.

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A power of attorney under the Nebraska Uniform Power of Attorney Act is not valid unless it is acknowledged before a notary public or other individual authorized by law to take acknowledgments.
This power of attorney authorizes another person (your agent) to make decisions concerning your health care (you are the principal). Your agent will be able to make decisions and act with respect to your health care if it is determined you are incapable of making health care decisions for yourself.
If you choose to do so, place those instructions or limitations on the line as indicated. The Power of Attorney for Health Care form must be signed in the presence of TWO witnesses OR a notary to be valid.
The Cons of a Healthcare Power of Attorney Develop a new health condition that changes which types of treatment you want or need to receive. Have a falling out with the person to whom you designated power of attorney or otherwise decide that you no longer want them to have that power.
The Bottom Line. A healthcare proxy makes decisions related to healthcare on your behalf and can only act if you are medically or legally incapacitated. A power of attorney makes legal and financial decisions on your behalf and acts based on the scope of authority and under the conditions you have given them.
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People also ask

A Nebraska tax power of attorney (Form 33) is used by a taxpayer to have another party represent them before the Nebraska Department of Revenue. This form allows the representative, or attorney-in-fact, to appear in hearings, negotiate settlements, file returns, and receive notices and communications.
Note that a medical power of attorney doesnt give your agent the authority to make financial decisions on your behalf including paying for your medical care. For that, you would need a separate financial power of attorney to oversee your finances.

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