Arizona health care power of attorney is legal document gives your agent broad powers to make health care decisions for you
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You make decisions about your health care. No health care may be given to you over your objection, and necessary health care may not be stopped or withheld if you object - medical power of attorney - hcpoa |
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The issuance of an Arizona Statutory Health Care Power of Attorney is regulated by AZ Revised Statute paragraph 36-3221.
You have the right to make decisions about your health care. No health care may be given to you over your objection, and necessary health care may not be stopped or withheld if you object. This is an important legal document. It gives your Agent broad powers to make health care decisions for you. It revokes any prior power of attorney for health care that you may have made. If you wish to change your Health Care Power of Attorney, you may revoke this document at any time by destroying it, by directing another person to destroy it in your presence, by signing a written and dated statement or by stating that it is revoked in the presence of two witnesses. If you revoke, you should notify your agent, your health care providers and any other person to whom you have given a copy. If your agent is your spouse and your marriage is annulled or you are divorced after signing this document, the document is invalid. You may also use the Arizona health care power of attorney to make or refuse to make an anatomical gift upon your death. If you use this document to make or refuse to make an anatomical gift, this document revokes any prior document of gift that you may have made. You may revoke or change any anatomical gift that you make by this document by crossing out the anatomical gifts provision in this document. Do not sign this document unless you clearly understand it. It is suggested that you keep the original of this document on file with your physician. Use this Health Care Power of Attorney form if you want to designate a person to make future health care decisions for you so that if you become too ill or can not make those decisions for yourself the person you choose and trust can make medical decisions for you. Do not sign this form until your witnesses or a notary public is present to witness the signing. In paragraph 1.1 you name your Agent, or attorney-in-fact, who will make health-related decisions for you. The types of health-related decisions you authorize may include, but are not limited to, the following: to consent or to refuse medical care, including diagnostic, surgical, or therapeutic procedures; to authorize the physicians, nurses, therapists and other health care providers to provide health care services for you; to approve or deny your admittance to the hospital and other health care institutions and programs. By signing this power of attorney you understand that you allow your Agent to make decisions about your mental health care, except that he/she can not, only by using this form, put you on an intensive mental health treatment program [in a faculty] called a "level one" behavioral health facility. In paragraph 2.1 you will state your desires regarding autopsy. Please remember that under Arizona law, an autopsy is not required unless the county medical examiner, or county attorney, or a court judge orders it to be performed. Please initial only one of the options. In paragraphs (1.3) through (2.1) you will see a series of statements. If you agree with the statement please insert your initials in the brackets in capital letters. If you do not agree with the statement or do not want to grant such power to your Agent, do not place your initials in the brackets. Please be advised that if you have a Living Will, you must attach it to this power of attorney. If you are physically unable to sign or mark the Arizona Health Care Power of Attorney, the notary or each witness shall verify on the document that you, as Principal, directly indicated to the notary or witness that the Health Care Power of Attorney expressed your wishes and that you intended to adopt it at that time. |
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