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Click ‘Get Form’ to open it in the editor.
Begin by filling in your full name and address in the 'APPOINTMENT OF HEALTH CARE AGENT' section. This identifies you as the Principal.
Next, designate your chosen agent by entering their full name and address. Ensure this person is someone you trust with your medical decisions.
In the 'LIMITATIONS ON MY AGENT' section, specify any restrictions on your agent's authority if applicable.
If desired, appoint an alternate agent by providing their details in the 'APPOINTMENT OF ALTERNATE AGENT' section.
Indicate where the original document will be filed and list individuals who will receive copies of this document.
Complete the 'DURATION' section to clarify how long this document remains valid, including any optional expiration date.
Finally, sign and date the document in the 'EXECUTION' section, ensuring that it is witnessed or notarized as required.

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