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Home Personal & Family Documents Power of Attorney Medical Connecticut

Free Connecticut Health Care Power of Attorney

Use our Connecticut Medical Power of Attorney form to let someone make medical decisions for you if you become unable to do so.

Updated November 20, 2020

A Connecticut (CT) medical power of attorney (MPOA) gives an appointed healthcare representative the right to make decisions for you if you become incapacitated. Your healthcare representative can make decisions only if your doctor determines you’re too sick or otherwise unable to make your own decisions.

Laws: Sections 19a-570 to 580 of the Connecticut General Statutes Title 19a – Public Health and Well-Being Chapter 368w – Removal of Life Support Systems governs how healthcare representatives are appointed.

Consider adding the following documents, which are related to the medical power of attorney:

  • Living Will: This document gives you control over how you want to handle your end-of-life treatment options.
  • Connecticut (Financial) Power of Attorney: This document provides consent for a healthcare representative to make business, financial, and non-medical decisions for your estate.

How to Fill in a Medical Power of Attorney in Connecticut

Follow the steps below to ensure that your medical power of attorney conforms to Connecticut law.

Step 1: Choose an agent

Your healthcare representative or agent can make medical decisions that impact your quality of life and, ultimately, whether you live at all.

Who should you choose as an agent?

Choose an adult age 18 and up who knows your wishes and who you trust to carry them out.

Your agent will make healthcare determinations that are consistent with your ethical, moral, and religious beliefs. Your agent is also expected to exercise their own judgment in regard to your wishes.

Relevant law: CGA 19a-576

Who can’t be your agent?

Certain individuals cannot be your agent, including:

  • Your attending physician or person providing care in a residential care facility
  • An employee of a hospital or residential care facility where you reside

Relevant law: CGA 19a-576

Can you have more than one agent?

Yes, you can have more than one agent.

If you list a second person on the form, they can act as your alternate representative when the first person listed is unable or unwilling to make decisions for you.

Step 2: Specify what healthcare decisions your agent can make

You can include specifics on what decisions your healthcare agent can make for you. This includes any limitations you wish to put in place.

Can you limit your agent’s powers?

Yes, to limit your agent’s powers, including the limitations in the medical power of attorney document.

Be clear on any exceptions by writing them down on the document. For instance, you can write, “I do not want to donate my organs after my death.”

What is your agent legally unable to do?

Your agent cannot approve of the following procedures:

  • Abortion
  • Committing you to an inpatient mental health services
  • Shock treatment or psychosurgery
  • Withholding comfort care such as pain relief

Relevant law: CGA 19a-575a

When can your agent start making decisions for you?

Your agent can start making decisions for you after the attending physician determines that you are incapacitated.

Relevant law: CGA 19a-579

Step 3: Sign the form

Below, you will find details of how to properly execute your medical power of attorney (MPOA).

Do you need notary or witness signatures?

Your Connecticut MPOA is legal only if it is in writing. Additionally, the document requires notarization and must be signed in front of the notary and two competent witnesses over 18 years of age.

Relevant law: CGA 19a-576

Who can be a witness?

At least one of your two witnesses can’t be:

  • Your healthcare representative
  • Your physician
  • Your physician’s employee
  • An employee of the health facility in which you’re a patient

Relevant law: CGA 19a-576

How long is your Connecticut medical power of attorney effective?

Your Connecticut MPOA remains in effect until you revoke it or you become competent to make your own decisions. You can also put an expiration date on the document if you want it to be temporary.

How to Revoke a Connecticut Medical Power of Attorney

You can revoke your medical power of attorney at any time and in any manner by expressing your wishes orally or in writing, for example:

  • Draft a written revocation of power of attorney form
  • Tell your physician you wish to revoke the medical power of attorney

Your physician is legally bound to respect your wishes.

Relevant law: CGA 19a-579

 

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