• Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Legal Templates

Legal Templates
  • Business Forms
    Business & Contracts

    All of our legal contracts and documents are drafted and regularly updated by attorneys licensed in their respective jurisdictions, paralegals, or subject matter experts. Save your hard-earned money and time with Legal Templates.

    Top Business Forms
    Business Formation
    • Business Plan
    • LLC Operating Agreement
    • Articles of Incorporation
    • Corporate Bylaws
    • Buy-Sell Agreement
    Business Operations
    • Business Contract
    • Partnership Agreement
    • Non-Disclosure Agreement
    • Release of Liability
    • Letter of Intent
    Sales and Payments
    • Purchase Agreement
    • Sales Agreement
    • Invoice
    • Purchase Order
    • Business Purchase
    Employment and HR
    • Employment Contract
    • Employment Offer
    • Employment Verification
    • Freelance Contract
    • Non-Compete Agreement
    View All Business Forms
  • Real Estate Forms
    Real Estate

    All of our legal contracts and documents are drafted and regularly updated by attorneys licensed in their respective jurisdictions, paralegals, or subject matter experts. Save your hard-earned money and time with Legal Templates.

    Top Real Estate Forms
    Landlords
    • Lease Agreement
    • Property Management
    • Eviction Notice
    • Late Rent Notice
    • Lease Termination
    Tenants
    • Room Rental
    • Sublease Agreement
    • Roommate Agreement
    • Notice to Vacate
    • Early Lease Termination
    Home Ownership
    • Real Estate Purchase Agreement
    • Mortgage Deed
    • Quitclaim Deed
    • Deed of Trust
    • Moving Checklist
    View all Real Estate Forms
  • Personal & Family Forms
    Personal and Family

    All of our legal contracts and documents are drafted and regularly updated by attorneys licensed in their respective jurisdictions, paralegals, or subject matter experts. Save your hard-earned money and time with Legal Templates.

    Top Personal and Family Forms
    Estate Planning
    • Power of Attorney
    • Last Will & Testament
    • Living Will
    • Advance Directive
    • DNR Form
    Personal Finance
    • Bill of Sale
    • Loan Agreement
    • Purchase Agreement
    • Promissory Note
    • Sales Agreement
    Family Matters
    • Parenting Plan
    • Child Travel Consent
    • Divorce Agreement
    • Separation Agreement
    • Prenuptial Agreement
    Affidavits
    • General Affidavit
    • Gift Affidavit
    • Affidavit of Identity
    • Affidavit of Residence
    • Affidavit of Death
    View All Personal Forms
  • Support
    Resources
    • Business
    • Real Estate
    • Personal and Family
    • Financial
    • Estate Planning
    Support
    • About Us
    • Careers
    • Contact Us
    • All Legal Documents

    Monday - Friday | 9AM - 7PM EDT

    (855) 335-9779

  • Sign In
  • :email

Home Personal & Family Documents Power of Attorney Medical Indiana

Indiana Medical Power of Attorney

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

Updated April 20, 2022 | Legally reviewed by Susan Chai, Esq.

A Medical Power of Attorney (MPOA) allows you to name a person or entity, called an “agent” or “representative”, to make healthcare decisions on your behalf if you’re incapable of making those decisions yourself. Your agent can let doctors know your wishes and make important healthcare decisions for you if you’re unconscious or unable to communicate.

Laws: Title 16, Article 36 of the Indiana Code governs the creation of medical powers of attorney in Indiana.

In addition to your Medical POA, consider creating the following complementary documents:

  • Living Will: A Living Will outlines your healthcare wishes. If you have an MPOA, your agent must abide by the wishes you describe in your living will.
  • Indiana Financial Power of Attorney: A financial power of attorney allows you to appoint an agent to handle your financial affairs should you become incapacitated. You can give your financial agent the power to handle affairs like buying and selling real estate, managing your bank accounts, and paying your bills.

How to Fill in a Medical Power of Attorney in Indiana

Follow these steps to fill out your MPOA according to Indiana Code §16-36.

Download an Indiana Medical Power of Attorney Form

Use the templates below to guide you as you draft your own IN Medical Power of Attorney:

Download: PDF | Word

Step 1: Choose an Agent

Your agent (health care representative) is responsible for your medical decisions if you become incapacitated.

Who should you choose as an agent?

The agent you choose should have a good understanding of your wishes relating to health care. They must be 18 years old or older and should be someone you trust to make important, possibly difficult, medical decisions on your behalf.

Indiana law also allows you to appoint an entity like a trust or an LLC to act as your representative.

Relevant law: IC §16-36-1-7

Who can’t be your agent?

The following people can’t be your MPOA agent:

  • Anyone under the age of 18
  • A legally separated spouse or current spouse officially seeking divorce, separation, or annulment
  • A person who can’t contact you due to a protective order or restraining order
  • Any person with pending criminal charges that allege you as the victim

Although there are no specific laws about it, you should also ensure that your agent doesn’t have a conflict of interest, such as providing you with medical care (your doctor) or being named to inherit from your estate (your beneficiary).

Relevant law: IC §16-36-1-9.5

Can you have more than one agent?

You cannot have multiple agents at one time, but you can name a successor agent if your appointed agent is unable or unwilling to act.

Relevant law: IC §16-36-1-7

Step 3: Specify what healthcare decisions your agent can make

Indiana law doesn’t place many restrictions on health care agents’ powers, so it’s important to leave instructions in the document.

Can you limit your agent’s powers?

Yes, you can specify the decisions you don’t want your healthcare agent to make on your behalf in your MPOA document.

If you choose not to limit your agent’s power, they’ll be able to do any of the following:

  • Access and release your medical records to others
  • Refuse or consent to medical procedures
  • Admit you to a healthcare facility
  • Request an autopsy
  • Decide whether to donate your organs
  • Make funeral arrangements

You can also describe your specific wishes regarding these decisions in your MPOA document so your agent and doctors know how to proceed.

Relevant law: IC §16-36-1-6

What is your agent legally unable to do?

Your agent can’t do any of the following according to Indiana law:

  • Authorize euthanasia
  • Withdraw or withhold life-sustaining care if you’re pregnant
  • Make any decisions that go against your wishes

Additionally, unless you specifically give authorization in the document, your agent can’t choose someone else to serve as your agent in their place.

Relevant law: IC §16-36-1-7 and IC §16-36-12

When can your agent start making decisions for you?

In Indiana, your Medical Power of Attorney only goes into effect when you can’t consent to care or treatments on your own. That means your agent will no longer be able to make decisions about your health care if you regain decision-making capacity after a period of incapacity.

Relevant law: IC §16-36-1-7

Sign the form

You must sign the form for your Medical Power of Attorney to be valid in Indiana.

Does a Medical Power of Attorney need to be notarized in Indiana?

Indiana law doesn’t require you to have the document notarized. You must have at least one adult witness your signature.

Relevant law: IC §16-36-1-7

Who can’t be a witness?

Legally, the only people who can’t serve as a witness to your Indiana MPOA are:

  • Your agent
  • Anyone under the age of 18

We recommend choosing someone who doesn’t have any personal interest in the agreement and knows you well enough to affirm your competence and willingness to sign.

Relevant law: IC §16-36-1-7

How long is your Medical Power of Attorney effective in Indiana?

Your Indiana medical POA is effective indefinitely until you revoke it. If you wish, you can also specify a certain date when the form expires.

Relevant Law: IC §16-36-1-7

How to Revoke an Indiana Medical Power of Attorney

If you want to revoke your Medical Power of Attorney, you can do so with any of the following methods:

  • Create a written Revocation of Medical Power of Attorney form
  • Revoke your agent’s powers verbally or in writing
  • Notify your health care provider orally or in writing of your wish to revoke

Although you can revoke your Medical Power of Attorney orally in Indiana, we recommend recording the revocation and sharing copies with the involved parties.

Relevant law: IC §16-36-1-7 and IC §16-36-1-6

Related Will & Estate Planning Documents

  • Indiana Power of Attorney: An Indiana Power of Attorney is a written document that officially recognizes a legally binding relationship between two parties -- a Principal and an Agent....
  • Indiana Durable Power of Attorney: Free durable power of attorney form for Indiana (IN). Download in fillable PDF and Word formats. Meets all 2021 Indiana DPOA requirements.
  • DNR Form: States that you refuse resuscitation via CPR in the event that your heart stops beating or you stop breathing.
indiana medical power of attorney form

Free Indiana Medical Power of Attorney Form

Create Your Indiana Medical Power of Attorney in Minutes!

Legal Documents

  • All Legal Forms
  • Business Forms
  • Real Estate Forms
  • Personal and Family Forms

Popular Forms

  • Lease Agreements
  • Power of Attorney Forms
  • Eviction Notice
  • Living Will
  • Non-Disclosure Agreement

Resources

  • Legal Resources
  • Business
  • Real Estate
  • Personal & Family
  • Estate Planning
  • Financial
  • Covid-19 Resources

Company

  • Pricing
  • About Us
  • Careers
  • Contact Us
  • Partner With Us
  • Legal Dictionary

Users

  • Account
  • Terms of Use
  • Privacy Policy
  • Do Not Sell My Personal Information
McAfee - Together is power.
Trustpilot
BBB Accredited Business

(855) 335-9779, Monday-Friday, 9AM - 7PM EDT

Facebook Twitter LinkedIn

Copyright 2023 Legal Templates LLC. Legal Templates LLC is not a lawyer, or a law firm and does not engage in the practice of law. Legal Templates cannot and does not provide legal advice or legal representation. All information, software and services provided on the site are for informational purposes and self-help only and are not intended to be a substitute for a lawyer or professional legal advice. Use of this site is subject to our Terms of Use. Legaltemplates.net is owned and operated by Resume Technologies Limited, London with offices in London United Kingdom.”

Esc

Indiana Medical Power of Attorney

The document above is a sample. Please note that the language you see here may change depending on your answers to the document questionnaire.

Fill in the details

Thank you for downloading one of our free legal templates!

Would you leave us a review?

We hope you've found what you need and are able to avoid the time, costs, and stress associated with dealing with a lawyer.

A review would mean the world to us (it only takes about 15 seconds).

Please check your download folder for MS Word or open tabs for PDF so you can access your FREE Legal Template Sample

Thanks again, and good luck!

Leave My Review