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MASSACHUSETTS HEALTH CARE PROXY 2026
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- Click ‘Get Form’ to open the MASSACHUSETTS HEALTH CARE PROXY in the editor.
- At the top of the form, print your full name and address. Then, enter the name, address, and phone number of your chosen Health Care Agent. Optionally, you can also name an Alternate Agent.
- Decide if you want to set any limitations on your Agent's authority. If you wish for them to have full authority, leave this section blank; otherwise, specify any limitations.
- Before signing, ensure two adults are present as witnesses. Sign the document yourself or have someone sign on your behalf if you're physically unable.
- Have your witnesses fill in the date and their details after witnessing your signature.
- Optionally, on the back of the form, have your Agent and Alternate Agent sign statements acknowledging their roles.
- After completing the form, remove this instruction page and make at least four photocopies. Distribute copies to relevant parties such as your doctor and family members.
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Photocopies of this Health Care Proxy shall have the same force and effect as the original and may be given to other health care providers. My Health CareRead more
A healthcare proxy form lets you name someone to make decisions about your medical care including decisions about life support if you can no longer speak