Table of Contents
- Download an Arizona Medical Power of Attorney Sample
- The Basics: What is an Arizona Medical Power of Attorney
- Why Should You Have a Medical Power of Attorney?
- How to Select Your Agent(s)
- What Decision Making Power Will Your Agent Have?
- What to Do if You Change Your Mind
- Completing Your Arizona Medical Power of Attorney
1. Download an Arizona Medical Power of Attorney Sample
Your Free Arizona Medical Power of Attorney Download
2. The Basics: What is an Arizona Medical Power of Attorney
An Arizona Medical Power of Attorney (or “Durable Health Care Power of Attorney”) allows you to designate an agent to make healthcare decisions as well as funeral and disposition arrangements on your behalf—in the event of your incapacitation or death (A.R.S. § 36-3221).
Your agent will ensure that your healthcare desires are represented and decisions regarding your medical care are made with your best interests and personal values in mind. Completing a Health Care Power of Attorney form will answer these important questions if you become unable to communicate your wishes:
- Who will carry out my medical choices after I am unable to do so?
- What types of treatment do I want – and not want – to receive?
- Will my moral, religious, and other beliefs be followed with regard to my treatment?
In order to fully understand your Arizona Health Care Power of Attorney, it’s important to be aware of a few key terms as defined in A.R.S. § 36-3201:
- Principal: The person who has completed a Health Care Power of Attorney form (you).
- Agent: An adult who has been given authority by the principal to make healthcare decisions on their behalf, in accordance with their healthcare power of attorney document. An agent may also sometimes be referred to as a “surrogate.”
- Attending Physician: The physician who has the primary responsibility over your healthcare.
- Health Care Provider: A person, hospice, or organization that is licensed under the appropriate title or chapter of the Arizona State Legislature that renders healthcare designed to prevent, diagnose, or treat illness or injury.
Please be aware that a Medical Power of Attorney form can also be referred to as an:
- Health Care Power of Attorney
- Durable Health Care Power of Attorney
- Health Care Directive
3. Why Should You have a Medical Power of Attorney?
Regardless of your health or age, it’s important to be prepared for potential life-threatening and debilitating medical emergencies. While it can be difficult to contemplate, a situation may arise in which you are incapable of communicating your health care desires. Examples of such dilemmas can include:
- Experiencing an unforeseen complication while under general anesthesia
- Developing a form of dementia, leaving you unable to communicate rationally
- An indefinite vegetative state
- Suffering an injury or sickness that puts you into a coma
- Entering the advanced stages of a debilitating terminal illness
Unfortunately, these are only a few examples of conditions that could render you incapable of disclosing your healthcare wishes.
An Arizona Medical Power of Attorney will ensure that your healthcare decisions will be placed into the hands of someone you trust. Furthermore, laying out your exact wishes in this document, will relieve your friends and family from making uninformed, difficult choices on your behalf.
4. How to Select Your Agent(s)
Deciding who to appoint as your healthcare agent is, of course, an extremely personal choice. It’s important to select someone who is not only aware of your personal desires, but will also be mindful of your best interests. You should also be sure that you appoint someone able to carry out your directions in the midst of difficult, often emotionally charged situations.
Who can/can’t you select as your agent?
In Arizona, you may designate any adult to make healthcare decisions on your behalf (A.R.S. § 36-3221). Therefore, you may ask your domestic partner, spouse, adult child, parent, sibling, attorney, fiduciary, or anyone else to act as your agent.
However, the individual who signs as a witness on your Arizona Medical Power of Attorney form cannot be your agent, and vice versa (A.R.S. § 36-3221).
Can you have more than one agent?
Arizona allows you to choose one agent and two alternate agents, in case your first choice is incapable of acting as your agent for any reason.
5. What Decision Making Power Will Your Agent Have?
What Healthcare Decisions Are Your Agent(s) Able Make on Your Behalf?
As laid out in A.R.S. § 36-3221, once you become incapacity your agent will gain the authority to make any and all healthcare decisions for you. Such decisions may include:
- Whether to administer or remove life support
- When to continue or discontinue certain treatments
- What type of treatments you will receive
- Decisions concerning organ donation
In Arizona, your agent also has the authority to make your funeral and disposition arrangements–subject to any limitations you’ve outlined in your Health Care Power of Attorney form.
What Healthcare Decisions Are Your Agent(s) Unable to Make on Your Behalf?
Your agent can make any healthcare decisions on your behalf, unless you expressly limit the decisions they’re able to make in your Medical Power of Attorney document as stated in A.R.S. § 36-3223.
If you have not laid out specific healthcare desires in your medical power of attorney form, your agent must act in your best interest as they see fit, and in accordance with their own personal knowledge of your wishes.
6. What to Do if You Change Your Mind
How Long is Your Medical Power of Attorney Effective?
In Arizona, a Medical Power of Attorney form is valid and enforceable unless/until your agent’s authority is revoked by the principal (you), or by a court order (A.R.S. § 36-3223).
How to Revoke an Arizona Medical Power of Attorney
As stated in A.R.S § 36-3202, Arizona allows to revoke your healthcare directive or disqualify your agent at any time by doing any of the following:
- Creating a written document stating the revocation of your medical power of attorney or disqualification a surrogate
- Verbally notifying your agent or any healthcare provider
- Making a new medical power of attorney document
- Any other act that communicates your specific intention to revoke medical power of attorney or disqualify your agent
7. Completing Your Arizona Medical Power of Attorney
To complete a valid Arizona Medical Power of Attorney in accordance with A.R.S. § 36-3221-3224, you must create a written document that:
- Contains language clearly indicating that you wish to create a medical power of attorney document
- Designates your agent (and alternate, if you choose to include one)
- Is signed and dated by the principal (you), unless you’re physically unable to sign the document in which case, your notary or witness is shall verify that you intended to adopt the power of attorney at that time
- Is notarized OR signed and dated by one adult witness.
Please note that the following individuals are unable to act as your notary or witness:
- Your agent or alternate agent(s)
- An individual directly involved in providing your healthcare services at the time you medical power of attorney is executed
What to do with Your Signed Form
Once you’ve completed your medical power of attorney form, it’s crucial that you provide a copy to your agent and alternate agents. In addition, you should administer a copy to your doctor, attorney, as well as any friends and family members you wish to keep informed of your decision.
Consider keeping a copy of the form on your person, such as in a wallet or purse. Make sure you bring a copy of the form with you if you are admitted to the hospital even for minor surgery or outpatient procedure.
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