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Home Personal & Family Documents Power of Attorney Medical Hawaii

Free Hawaii Medical Power of Attorney

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

Updated April 22, 2022 | Legally reviewed by Susan Chai, Esq.

A Hawaii (HI) Medical Powers of Attorney (MPOA) gives you the power to determine who will make health care decisions for you if you can no longer do so due to illness or injury.

The person you choose is called an agent and only gets to make choices for your healthcare if you are physically unable to do so.

Laws: Title 19. Health Section 327E. Uniform Health-Care Decisions Act regulates Medical Powers of Attorney in Hawaii

In addition to your medical power of attorney, the following forms can ease your mind, and prepare you for events out of your control:

  • Living Will: This document records your wishes for end-of-life treatment options. Medical Powers of Attorney and living will fall under a category of documents known as advance directives.
  • Hawaii (Financial) Power of Attorney: This document gives your agent the right to handle your business, financial, and other affairs not related to your health.

How to Fill in a Medical Power of Attorney in Hawaii

The steps below describe the basic information you need to fill out your Hawaii medical power of attorney and ensure that it’s legally binding.

Download a Hawaii Medical Power of Attorney Form

Use the template below to guide you as you begin filling out your HI medical power of attorney:

Download: PDF | Word

Step 1: Choose an agent

Choose a person who you trust to carry out your wishes, even if they don’t personally agree with your decisions.

If you don’t want to be resuscitated, for example, a close friend or relative may have a hard time carrying that out.

Who should you choose as an agent?

Choose a competent adult over the age of 18 who you trust to respect your wishes.

Remember that your agent will make healthcare decisions based on what they know about your moral and religious beliefs. Have a frank conversation, ensuring that they’re willing and able to take on the responsibility.

Relevant law: §327E-3

Who can’t be your agent?

Unless related to you through marriage or by blood, the agent can’t be the owner, employee, or operator of a healthcare facility where you receive care.

Relevant law: §327E-3b

Can you have more than one agent?

Yes, you can name more than one agent on your Hawaii medical power of attorney.

If an alternative agent is designated in addition to your primary agent, they will assume responsibility for your healthcare directives if your primary agent is unable or unwilling to do so.

Step 2: Specify what healthcare decisions your agent can make

Think carefully about the powers that you hand over to someone else regarding your health and well-being.

Can you limit your agent’s powers?

You can limit the power your agent has by specifying your wishes with regard to life support, artificial nutrition, and pain relief.

For example, you can specify “I do not give permission for my organs to be donated after I die” if your medical power of attorney form.

Relevant law: §327E-7

What is your agent legally unable to do?

Hawaii does not expressly place restrictions on what your agent cannot do.

Relevant law: §327E-5

When can your agent start making decisions for you?

Unless you state otherwise in your medical power of attorney form, your agent can make decisions after a physician determines that you’re incompetent to make your own decisions.

Relevant law: §327E-3

Step 3: Sign the form

Sign and date the form to ensure it has legal validity. Two witnesses are required.

Relevant law: §327E-3

Do you need notary or witness signatures?

Yes, the Hawaii medical power of attorney requires the following:

  • the signature of the principal (you) signed in front of a notary public, and
  • the signature of two witnesses over the age of 18

Relevant law: §327E-3

Who can be a witness?

The following cannot be witnesses:

  • You
  • A health-care provider
  • Healthcare provider or facility employee

At least one witness cannot be:

  • Related to you by blood or marriage
  • A beneficiary of your estate

Relevant law: §327E-3

How long is your medical power of attorney effective in Hawaii?

Your Medical Powers of Attorney (MPOA) will remain in effect until:

  • you revoke the MPOA
  • you recover enough to make your own healthcare decisions

There is no default expiration date on a Hawaii MPOA. However, you can specify in the document if you want the medical power of attorney to be temporary.

How to Revoke a Hawaii Medical Power of Attorney

You can take away the rights of your agent to make decisions for you by informing your physician of your decision to change or revoke your medical power of attorney.

Relevant law: §327E-4

Related Will & Estate Planning Documents

  • Hawaii Durable Power of Attorney: Free durable power of attorney form for Hawaii (HI). Download in fillable PDF and Word formats.
  • Hawaii Power of Attorney: Use our form builder to create and print Hawaii power of attorney documents for free.
  • Limited (Special) Power of Attorney: Use our free Limited (Special) Power of Attorney form to authorize an agent to handle specific matters on your behalf.
hawaii medical power of attorney form

Free Hawaii Medical Power of Attorney Form

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Free Hawaii Medical Power of Attorney

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