• 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 Mississippi

Free Mississippi Medical Power of Attorney Form

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

Updated March 16, 2022

A Mississippi (MS) medical power of attorney (MPOA) is a legal form that lets you appoint another individual to make healthcare decisions on your behalf should you become incapacitated. The person you choose, called your agent, must make decisions based on your wishes and in your best interest.

In Mississippi, a medical power of attorney can also be called a:

  • Mississippi Health Care Power of Attorney
  • Mississippi Medical POA

Laws: Title 41, Chapter 41, Sections 203-229 of the Mississippi Code govern medical powers of attorney in Mississippi.

Free Mississippi Medical Power of Attorney Form

Download: PDF | Word

Download an unfilled Mississippi MPOA template to serve as a guide for creating your own medical power of attorney form.

How to Fill in a Medical Power of Attorney in Mississippi

Take these steps to ensure your medical power of attorney is filled out according to MS Code §41-41-203 to §41-41-229:

Step 1: Choose an agent

Your agent is the person who will step in to make decisions about your health care if you become incapacitated and can’t communicate.

Who should you choose as an agent?

You can appoint any adult or emancipated minor as your agent, but it’s best to choose someone who understands your personal values in case your instructions in the MPOA document don’t specifically address a decision they need to make on your behalf.

Relevant law: MS Code §41-41-205

Who can’t be your agent?

You can’t select an employer, owner, or operator of the healthcare facility where you’re receiving treatment to be your agent unless you’re related to them by blood, marriage, or adoption.

Relevant law: MS Code §41-41-205

Can you have more than one agent?

You can appoint one or more alternate agents to take over in case your primary agent is unable to serve for any reason.

Relevant law: MS Code §41-41-205

Step 2: Specify what healthcare decisions your agent can make

As you fill out your MS medical POA, think about any restrictions you want to place on your healthcare agent’s powers and responsibilities.

Can you limit your agent’s powers?

Yes, you can decide what decisions your agent can make on your behalf and write your directions in the MPOA document. If you don’t limit your agent’s powers, they’ll have the right to make any medical decision you would normally make yourself (if you become incapacitated).

Examples of actions your MPOA agent could take include:

  • Decide on organ and tissue donation
  • Withdraw or withhold artificial nutrition and hydration
  • Access your medical records
  • Choose which medicines and treatments you receive

Relevant law: MS Code §41-41-209

What is your agent legally unable to do?

Your agent can’t make any healthcare decisions that are not in your best interest, or that go against the terms of the medical power of attorney (or another advance directive for health care).

Relevant law: MS Code §41-41-209

When can your agent start making decisions for you?

Generally, your agent can begin making medical decisions for you once you become incapacitated.  If you wish, you can allow your agent to start making decisions for you immediately or under different conditions by including your directions in the MPOA document.

Relevant law: MS Code §41-41-205

Step 3: Sign the form

Sign your MPOA according to the following requirements to make sure it’s legally binding in MS:

Do you need a witness or notary signature?

You must sign your MPOA in the presence of one of the following:

  1. Two adult witnesses who can confirm you’re of sound mind and signing willingly
  2. A notary public

Relevant law: MS Code §41-41-205

Who can’t be a witness?

Your witnesses can’t be:

  • Your healthcare provider or their employee
  • Your agent
  • An operator, owner, or employee of the facility where you’re receiving treatment

Additionally, one of your witnesses must be someone who’s neither:

  • Related to you by adoption, blood, or marriage, nor
  • Someone who will inherit from you after your death

Relevant law: MS Code §41-41-205

How long is your Mississippi power of attorney effective?

Your Mississippi medical power of attorney becomes effective after a doctor has determined that you’re incapacitated. The form is no longer effective once you regain capacity.

Relevant law: MS Code §41-41-205

How to Revoke a Mississippi Medical Power of Attorney

You can take any of the following actions to revoke your medical power of attorney in Mississippi:

  • Notify your healthcare provider in person or in writing
  • Create a new medical power of attorney, canceling the previous version
  • Create a written revocation of power of attorney form
  • Any other method that shows clear intent to revoke

Additionally, if your spouse is your agent, filing for a divorce or legal separation will automatically revoke their powers unless otherwise stated in the medical power of attorney document.

Relevant law: MS Code §41-41-207

As you plan who will make important medical decisions for you if you become incapacitated, consider also creating a financial power of attorney for Mississippi, which lets a trusted person handle certain aspects of your personal and financial affairs. You can decide if this power of attorney is effective all the time or under specific circumstances (like if you’re incapacitated).

Related Will & Estate Planning Documents

  • Living Will (Health Care Directive): Define your healthcare treatment and end-of-life decisions.
  • Advance Directive: Declare your health care wishes if you’re incapacitated and can’t make your own decisions.
  • Durable Power of Attorney: A Durable Power of Attorney (DPOA) form lets your agent act on your behalf in certain affairs if you become incapacitated.
Mississippi medical power of attorney form

Free Mississippi Medical Power of Attorney Form

Create Your Mississippi 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

Free Mississippi Medical Power of Attorney Form

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