Free Illinois Power of Attorney for Health Care

Table of Contents

1. Download an Illinois Power of Attorney for Health Care Sample
2. The Basics: What is an Illinois Power of Attorney for Health Care Form?
3. Who Should Have a Power of Attorney for Healthcare?
4. How to Select Your Agents
5. Decision Making Power Granted to Your Agent(s)
6. What to Do if You Change Your Mind
7. How to Complete Your Power of Attorney for Health Care Form

1. Download an Illinois Power of Attorney for Health Care Sample

Your Free Illinois Power of Attorney for Health Care Download

2. The Basics: What is an Illinois Power of Attorney for Health Care Form?

In Illinois, you can designate an agent to make important medical choices on your behalf if you become incapacitated in the future. The document outlining your wishes is known as the Illinois Power of Attorney for Health Care. This differs considerably from an Illinois power of attorney form, which allows you to grant an agent authority over your financial decisions—also in the event of your future incapacitation.

As you draft your Illinois medical power of attorney, you may encounter the following  important terms, as outlined in §755 ILCS 45/2-3:

• Principal: This is the person who completes the health care power of attorney granting powers to an agent. In other words: you.
• Incapacitated: According to Illinois law, you are incapacitated when you have a legal disability, as referenced in Section 11a-2 of the Probate Act of 1975. Otherwise, you can be declared incapacitated if a licensed physician has determined that you are incapable of making decisions for yourself.
• Attending physician: This term refers to the doctor who holds primary responsibility for your care at the time you become incapacitated.
• Agency: The written power of attorney governing the relationship between a principal and agent(s).
• Agent: The individual designated to act for the principal in the agency.

Please note that in Illinois a Power of Attorney for Health Care can also be referred to as a/an:

• Medical Power of Attorney
• Health Care Proxy

3. Who Should have a Power of Attorney for Health Care?

No matter your age, your health status, or where in Illinois you reside, you can benefit from planning for the future. Those plans should include worst-case scenarios, especially regarding your health and wellbeing. An Illinois Power of Attorney for Health Care can serve as a key tool for ensuring that you receive the level of care you desire when you are no longer able to express your wishes.

With powers of attorney, sooner is always better. Still, many people neglect these documents until they see major life events or changes, such as:

• Moving to a new state or country
• Marriage or divorce
• Pregnancy
• Adoption
• Starting a dangerous new job
• Acting as a caretaker for somebody who is severely ill or injured
• Unexpected medical diagnoses

4. How to Select Your Agent(s)

The agent highlighted in your power of attorney for health care will have broad authority over your medical future. Not just anybody can handle this weighty responsibility. Think carefully about whether prospective agents are capable of or willing to carry out your instructions.

Illinois Power of Attorney Act 755 ILCS 45/4-10 offers in-depth insight into considerations worth making. If you’re struggling to arrive at a decision, these key questions may help:

• Is this person old enough? According to 755 ILCS 45/4-4 e-5, your power of attorney for health care must be at least 18 years old.
• Can this person handle the emotional implications of this responsibility? Your agent may face a variety of difficult decisions. Not everybody is emotionally prepared for this challenge.
• Will this person act according to my wishes? When selecting an agent, you should feel confident, above all else, that your chosen representatives will honor any wishes outlined in your power of attorney for health care.
• What about personal beliefs? Will your preferred agent carry out your wishes even if they go against his or her moral or religious convictions?

Successor Agents

In addition to choosing a primary agent, you can select a second or even third agent, who would handle medical decisions if the primary agent is unable to do so.

Referred to in 755 ILCS 45/3-3 as successor agents, these individuals serve exclusively as a backup agent–if your primary agent is unavailable, unable, or unwilling to make decisions on your behalf. They can only act in the order in which they are listed in your Illinois medical power of attorney.

5. Decision Making Power Granted to Your Agent(s)

Your Illinois power of attorney grants your agent broad authority over your medical care as described in 755 ILCS 45/4-10. As soon as you are declared incapacitated, your power of attorney is able to:

• View your healthcare records without the need of a signed medical records release form
• Discuss your medical situation with your attending physician and other healthcare professionals
• Consent to or withdraw consent for specific medical treatments
• Permit autopsies or organ donations in the event of your death

While your agent is permitted to discuss your medical situation and treatment options with your loved ones, he or she has the final say. Your agent is only restricted by stipulations you’ve outlined in your medical power of attorney document.

Which Decisions Are Prohibited?

Unless you state otherwise, your agent is not restricted from making medical decisions. Your agent may, however, be barred from making certain decisions if you’ve stipulated as such in your power of attorney or living will.

6. What to Do if You Change Your Mind

While you may currently feel confident in your selected agent, this may change over time.

Fortunately, Illinois law allows for the revocation of powers of attorney for health care. 755 ILCS 45/4-6 outlines multiple methods for revoking your power of attorney, including:

• Creating a new power of attorney and designating another agent. Your new power of attorney for health care document automatically revokes any previous powers of attorney.
• Physical destruction of the original document. According to 755 ILCS 45/ 4-6, this could include burning, tearing, obliterating, or otherwise defacing the form in a manner indicating the intention to revoke.
• Writing and signing a formal revocation of power of attorney form.
• Verbal or any other expression of your decision to revoke in the presence of a witness 18+ years of age who signs and dates a confirmation of your revocation.

7. How to Complete Your Power of Attorney for Health Care Form

When you complete your Illinois medical power of attorney, you will outline the identity of your agent and any desired successor agents. Your form can include as many, or as few, details as you desire. Keep in mind that your agent will enjoy full decision-making power for any matters not outlined in your power of attorney.

According to 755 ILCS 45/ 4-5.1 your power of attorney document must bear the signature of a witness to the signing of the agency.  The witness must be at least 18 years old. Your agent is not allowed to act as your witness, nor are any of your successor agents. In addition to signing the document, your witness should include the date along with his or her address.

Illinois Power of Attorney Act 755 ILCS 45/ 4-5.1 prohibits the following individuals from serving as your witness:

• Your attending physician, advanced practice registered nurse, physician assistant, dentist, podiatric physician, optometrist, or psychologist.
• A relative of one of the licensed professionals described above.
• An owner, operator (including directors and executive officers), or a relative of an owner or operator of a health care facility in which you are a patient or resident
• A parent, sibling, or descendant, or the spouse of a parent, sibling or descent, of yourself of any of your appointed agent(s).

It’s never easy to plan for a future in which you may be incapacitated — but your efforts could provide much-needed solace for both you and your loved ones. Once you complete your Illinois power of attorney for health care, you can rest easy, knowing that your medical future lies in capable hands.