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Home Personal & Family Documents Power of Attorney Medical Kentucky

Free Kentucky Medical Power of Attorney

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

Updated May 15, 2022 | Legally reviewed by Susan Chai, Esq.

A Kentucky Medical Power of Attorney (MPOA) form is a document that lets you select a representative to make medical decisions for you if you become mentally or physically incapacitated.

Laws: The Kentucky Revised Statutes Title 26, Section 311.621 – 311.647 regulate the creation of medical powers of attorney in KY.

We recommend creating the following documents along with your MPOA to help communicate all aspects of your wishes in case of incapacitation:

  • Living Will: This document lets you provide instructions regarding the type of medical care you would like to receive if you’re unconscious or otherwise unable to voice your wishes. Living wills and medical powers of attorney are both types of advance directives and can appear on the same form in Kentucky.
  • KY (Financial) Power of Attorney: This document lets you choose an agent to manage your financial affairs (like paying bills or selling a property). You can give this person access to your finances immediately or only if you become incapacitated.

How to Fill in a Medical Power of Attorney in Kentucky

Take these steps to complete your medical power of attorney according to Kentucky requirements as outlined in Ky. Rev. Stat. §311.621-311.647:

Step 1: Choose an agent

Your agent, or health care surrogate, is responsible for making decisions about your health care if you can’t communicate your wishes.

Who should you choose as an agent?

Your agent must be at least 18 years old and should be someone you trust with sensitive medical affairs.

Ideally, your agent should also have a good understanding of your values regarding medical care in case they have to make a decision for you without knowing what you would have wanted.

Who can’t be your agent?

Generally, your agent can’t be the owner, director, or staff of a facility where you’re receiving health care (like a hospital or nursing facility). This restriction may not apply to blood relatives or members of the same religious or fraternal order.

Relevant law: Ky. Rev. Stat. §311.625

Can you have more than one agent?

Yes, you can appoint two or more individuals to act as co-agents if you wish. Unless you direct otherwise in your Medical Power of Attorney, your agents will have to unanimously approve any decisions made on your behalf.

You can also appoint one or more successor agents in case your primary agent is unable to serve.

Relevant law: Ky. Rev. Stat. §311.623

Step 2: Specify what healthcare decisions your agent can make

Consider what kind of decisions you’re comfortable with your agent making on your behalf during incapacitation.

Can you limit your agent’s powers?

Yes, you have substantial control over the powers provided to your agent. If you wish, you can give them permission to act only in specific situations.

Note that if you’re pregnant, your directions in the document may not apply.

You might want to provide specific instructions or limit your agent’s powers regarding the following decisions:

  • Visitation rights
  • Medical treatment decisions
  • Access to medical records
  • Selection of hospitals or other care facilities
  • Organ and tissue donation

If you don’t limit your agent’s powers, they’ll be able to make any decision you would normally make about your health care.

Relevant law: Ky. Rev. Stat. §311.629

What is your agent legally unable to do?

Your agent can’t make decisions for you while you still have the ability to make and communicate your wishes. The law also prevents your agent from going against your wishes as you’ve described them in the document.

When can your agent start making decisions for you?

Your agent can only begin making medical decisions on your behalf once your doctor determines you’re incapacitated and can’t make decisions on your own.

Step 3: Sign the form

Make sure your Medical POA is signed according to the following KY requirements:

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

Yes, to be valid, your Medical Power of Attorney must either be acknowledged by a notary public or signed in the presence of two witnesses (who must also sign the document). If you’re physically unable to sign, you can direct someone else to sign in your presence.

Relevant law: Ky. Rev. Stat. §311.625

Who can’t be a witness?

The following people can’t serve as your notary or witnesses:

  • Your blood relative
  • Anyone who will inherit from you
  • Your personal physician
  • Anyone financially responsible for your health care

Additionally, an employee of the health care facility where you’re a patient can’t be a witness, but they may serve as a notary public (if authorized to do so).

Relevant law: Ky. Rev. Stat. §311.625

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

Your Medical Power of Attorney is valid indefinitely until it’s revoked.

How to Revoke a Kentucky Medical Power of Attorney

As long as you have decision-making capacity, you can revoke all or part of your MPOA with any one of the following actions:

  • Verbally stating your intention to revoke in the presence of a health care provider and one other adult
  • Create a revocation of power of attorney form
  • Destroy the original document
  • Create a new MPOA form, automatically canceling the old one

Once you complete the revocation, make sure you notify your agent and any healthcare providers so they can note the change in your medical records.

Relevant law: Ky. Rev. Stat. §311.627

Related Will & Estate Planning Documents

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

Free Kentucky Medical Power of Attorney Form

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