Health care proxy wallet card 2026

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The New York State Health Care Proxy Wallet Card allows individuals to designate a Health Care Agent to make medical decisions on their behalf in emergencies. It provides instructions for completing the card, including reviewing relevant publications, obtaining necessary signatures from witnesses, and storing the card with important documents. The document emphasizes the importance of sharing the Health Care Proxy Form with medical providers and includes options for organ donation and special instructions regarding decision-making limitations.

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Click ‘Get Form’ to open the health care proxy wallet card in the editor.
Begin by entering your name as the Principal at the designated field. This identifies you as the individual granting authority.
Next, appoint your Health Care Agent by filling in their name and contact information. Ensure this person is someone you trust to make decisions on your behalf.
If applicable, indicate any limitations or special instructions regarding your Agent's decision-making powers in the provided section.
Complete the optional organ and/or tissue donation section if you wish to express your wishes regarding anatomical gifts.
After filling out all necessary fields, sign the card in front of two witnesses who are not your Agent. They must also sign to validate the document.
Finally, store the completed wallet card in a safe place within your wallet and share a copy of your Health Care Proxy Form with your medical providers.

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