Legal Templates

Arkansas Medical Power of Attorney Form

Updated November 13, 2024
Written by Ioana Gagiuc | Reviewed by Susan Chai, Esq.

An Arkansas medical power of attorney lets you pick someone to make healthcare decisions for you if you can’t speak for yourself. This person is called your agent and will handle your medical care if you’re unable to. In Arkansas, this form is also known as a durable power of attorney for healthcare.

Laws

Statute: § 20-6-101 to 20-6-117 (Arkansas Healthcare Decisions Act).

Signing Requirements: Two (2) Witnesses or Notary Public (AR Code § 20-6-103).

Revocation: It becomes ineffective upon your death, when you cancel it, or if a court cancels it. Also, if your spouse is your agent and you get an annulment or divorce, the document is automatically revoked unless it says otherwise (AR Code § 20-6-104).

Sample

Arkansas Power of Attorney for Healthcare form that includes sections for entering the principal’s details—such as full name, address, phone number, birth date, and email—and the healthcare agent’s information, including name, address, phone, and email.

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Arkansas Power of Attorney for Healthcare form that includes sections for entering the principal’s details—such as full name, address, phone number, birth date, and email—and the healthcare agent’s information, including name, address, phone, and email.

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

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