Printable health care proxy 2026

1. Click ‘Get Form’ to open the printable health care proxy in our editor.
2. In the first section, enter your name and appoint a health care agent by filling in their name, home address, and telephone number. This person will make health care decisions on your behalf if you are unable to do so.
3. If you have specific instructions for your agent regarding your health care preferences, write them in the optional instructions section. You can attach additional pages if necessary.
4. Designate a substitute agent by providing their name, home address, and telephone number in case your primary agent is unavailable.
5. Specify the duration of this proxy. If you want it to expire on a certain date or under specific conditions, indicate that clearly.
6. Sign the document and provide your address and date of signing. Ensure that two witnesses (who are at least 18 years old) also sign and provide their addresses.

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