Fillable Online Proxy Form A for EGM Fax Email Print 2025

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Two witnesses 18 years of age or older must sign this Health Care Proxy form. The person who is appointed your agent or alternate agent cannot sign as a witness.
All competent adults, 18 years of age or older, can appoint a health care agent by signing a form called a Health Care Proxy. You dont need a lawyer or a notary, just two adult witnesses.
A proxy form should include the name and contact details of the stakeholder, the name and contact details of the proxy, information about the meetings the proxy will replace the stakeholder at, as well as a signature to make this official.
A health care proxy form is a legal document that allows you to appoint someone you trust to make medical decisions on your behalf if you become unable to do so. This person, called a health care agent, acts based on your expressed preferences or best interests.
If you are an individual shareholder, you or your authorized attorney must sign the proxy form. Your attorney may have to provide proof of your authorization. For shares registered in the name of two or more owners, at least one of the holders must sign to be accepted.
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Making your health care proxy decision official You can find, download, and print free advance directive forms for your state. You may need to have your form witnessed or notarized, so be sure to read the directions closely. Get started by finding advance directive forms for your state.

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