Do You Need Healthy Care Proxy Examples When Creating Your Document?

Advance Health Care Directive Do You Need Healthy Care Proxy Examples When Creating Your Document?

Health Care Proxy Examples—Do You Need Them?

Composing a medical power of attorney—in some states also known as a health care proxy—isn’t a simple task. Many people get confused by the provisions they should include in the document and rely on online samples, which are often too generic for their needs.

Luckily, you can avoid health care proxy examples and advance directive forms and prepare a flawless document within minutes! Find out how to make the document you need without suspicious templates and enormous legal fees by signing up for DoNotPay!

General Definition of a Health Care Proxy

A health care proxy is a legal document that lets you delegate the rights to make health care decisions in your stead to another person. They act as your health care agent and decide on your behalf if you get permanently disabled or incurably ill.


The individual you appoint will be able to make choices related to almost all aspects of your medical and end-of-life care, including:

  • Treatments and medications
  • Artificial nutrition, hydration, and respiration
  • Cardiopulmonary resuscitation (CPR) and other life-sustaining interventions
  • Blood transfusions and dialysis
  • Tissue and organ donation

In some states, a health care (medical) proxy comes into effect only if you are terminally ill or in an irreversible coma. In others, it becomes effective in any situation in which you may be unable to speak or think clearly, such as:

  • Temporary unconsciousness
  • Stroke
  • Heart attack
  • Accident that caused injuries you can recover from

It’s crucial to separate this document from a regular power of attorney as the latter serves to assign a much broader spectrum of rights.

People usually pair a medical proxy with a living will. It represents a health care directive that lists your medical care wishes and preferences doctors should be aware of if you become unable to communicate.

Where Can You Find Medical Proxy Examples?

You can get health care proxy samples from a few sources. They are presented in the following table:

Way To Find Medical Proxy Examples Explanation
Health care institutions Some health care organizations offer acceptable medical proxy examples or forms. The content of these templates depends on the state you live in. Since each has specific requirements related to medical powers of attorney, you should double-check if the provided form matches your state’s criteria
State laws State codes often include a section featuring a recommended medical proxy form. Once you find it, you can modify it according to your needs and complete it with valid info
Online resources You can find many medical power of attorney examples online. The main disadvantage of this option is that the available samples are often too generic or don’t contain all the necessary provisions

What Should a Medical Proxy Letter Sample Include?

Here is the information each medical power of attorney should provide, regardless of the state requirements:

  1. The name and birth date of the principal—the person who appoints a health care agent
  2. Declaration stating the legal name and home address of the designated agent
  3. Secondary (alternate) agent info—if the primary agent becomes unable or unwilling to act on the principal’s behalf
  4. Transferred rights and powers
  5. Limitations and special instructions
  6. Date of signing
  7. Signatures of all parties involved
  8. Witness(es)’ signature(s)

In Need for a Quick and Seamless Medical Proxy? Use DoNotPay!

If you decide to use a health care proxy sample, you will have to adapt it to your needs. This often includes rewriting or composing the document from scratch, which can be time-consuming and tiring.

DoNotPay has come up with an AI-based tool that can:

  • Gather all the info about your medical care preferences
  • Create a unique living will or medical power of attorney in your stead
  • Enable you to arrange an online appointment with a notary and get the document notarized with minimal effort

To use the tool, you should proceed as follows:

  1. Sign in to DoNotPay
  2. Select Advance Health Care Directive
  3. Fill out the required fields related to your agent and witnesses
  4. Answer quick questions about the desired future medical and end-of-life care

Once you follow the prompts above, we will provide you with a personalized document in less than a few minutes!

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