Free Fillable Pennsylvania Medical Power of Attorney Form

Why would you need a Pennsylvania medical power of attorney form? It is typical for people to think that they will live forever, prospering and flourishing day by day. However, harsh reality sometimes introduces corrections into the grandiose plans of individuals. A severe debilitating illness or a car accident may ruin one’s health, thus depriving the individuals of the possibility to make decisions about their health, well-being, and the like on their own.

Having a free power of attorney form signed and registered is a great way out of the problematic situation. Once you get ill or incapacitated, you may rest assured that a trusted agent acting in good faith can protect your best interests and take care of your needs.

Pennsylvania power of attorney templates – access more power of attorney templates for Pennsylvania with instructions.

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Pennsylvania Requirements

The completion of medical POA in Pennsylvania is regulated by Title 20, Chapter 54 of the 2019 Pennsylvania Consolidated Statutes. Those who plan to have such an arrangement with a trusted agent should bear the following minimum requirements in mind:

The principal should be 18 years of age and older;
They should be of sound mind;
They should have a high school graduation diploma;
They should either be married or be an emancipated minor.

If any of these conditions apply to the person planning to complete a medical POA, the document will have the legal force.

Filling out the Pennsylvania Medical POA

To fill out the Pennsylvania medical power of attorney form, you may upload a ready template from our website, print it out, and fill out all the required sections. The file is available in all popular formats, including PDF, Word, and ODT, for your convenience. Another way to use our templates is to build your own form with an online step-by-step builder.

So, to complete the legally binding medical POA, you should:

Stipulate Your Personal Details

At the beginning of the POA form, you need to indicate your name and the country of your residence. The initial section is a standard text about the POA’s legal effect, the principal’s voluntary authorization of the agent to act on their behalf, and the relevant legislation under which the agent acts. It also enumerates the medical activities that an agent can authorize, including medical care and surgical procedures, medically supplied food and nutrition, residential facility or hospice accommodation, legal actions related to medical issues, and hiring/firing medical and nursing personnel to cater to the principal’s needs.

Appoint an Agent

The second section requires the provision of full information about the assigned agent. Their full name, relationship to the principal, address, telephone number, and email should be indicated. The full data is needed for the legal authorities to get in touch with the agent once their decision or action is required.

Appoint Alternative Agents

In case the primary chosen agent is unable to perform the assigned duties at the moment when assistance is required, your alternative agents can step in and manage all the issues. To make this happen, mention at least two alternative agents in your medical POA and give their particulars as well.

Complete the Optional Sections

With your data and the agent’s credentials being the mandatory minimum of what you need, probably that’s the end of POA completion. However, if you have some particular medical or after-death preferences, please indicate them in the document. Optional sections include instructions for health care agents in terms of:

Severe brain damage
Organ donation

Sign the POA

The final section of the Pennsylvania POA form is meant for notarization, but overall, it is optional. For your medical POA to take legal effect, it has to be signed in the presence of two witnesses only.