New York State Health Care Proxy Form - 2026

1. Click ‘Get Form’ to open the New York State Health Care Proxy Form in our editor.
2. Begin by filling in your name at the top of the form, followed by the name of the person you are appointing as your health care agent. Ensure you include their address and telephone number for clarity.
3. In the optional instructions section, specify any wishes or limitations regarding your health care decisions. If necessary, attach additional pages for more detailed instructions.
4. Designate a substitute agent by providing their name, address, and telephone number in case your primary agent is unable to act.
5. Indicate how long this proxy will remain effective. You can choose to leave it indefinite or specify a date or conditions for expiration.
6. Sign and date the form at the bottom. Ensure that you also provide your address.
7. Finally, have two witnesses sign and date the document, confirming they know you and that you are acting of your own free will.

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