This form gives the person you choose as your agent the authority to make all health care decisions for you, including the decision to remove or provide life-sustaining treatment, unless …

Before appointing someone as your health care agent, discuss your health care wishes and this form with them to make sure he or she is willing to act as your proxy.

I, ____________________________________________________________ hereby appoint ____________________________________________________________ (name, home …

Aug 9, 2010 · Attached is a health care proxy form that you can complete for your records. Once you complete a health care proxy, hospitals, doctors and other health care providers must …

In section (6), if you will be donating any organs/tissues, sign and date the appropriate lines. If you do not state your wishes on this form, the law does allow other individuals to make this …

Nov 1, 2024 · This form from the State of New York allows you to identify someone who can make decisions on your behalf if you’re not able to make them for yourself. To view this resource, …

To the best of our knowledge, the above named principal is at least eighteen years of age, of sound mind, and willingly executed this document in our presence under no constraint or …

Aug 27, 2025 · What Is a Proxy Form and How Does It Work? Learn what a proxy form is, its purpose, and how to effectively use this document to assign authority for important decisions.

The following pages explain the Health Care Proxy and Living Will, and present you with examples of each. You can use these forms and keep them accessible with other important …

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 don’t need a lawyer or a notary, just two adult witnesses. …