A Massachusetts health care proxy form is a document that lets you select someone to make medical decisions on your behalf if you lose your decision-making ability. The person you choose (called your agent) is required by law to carry out your wishes for medical treatment and act in your best interest.
Laws
Statute: Chapter 201D of the Massachusetts General Laws.
Signing Requirements: Your healthcare proxy needs to be signed in the presence of two witnesses. If you physically cannot sign, you can direct someone to sign for you. Your witnesses must be at least 18 years old, of sound mind, and able to confirm that you’re signing willingly. The person you choose as your agent can’t serve as a witness (M.G.L. ch.201D §2).
Revocation: Unless a court order determines you can no longer make decisions for yourself, you can revoke your health care proxy at any time. If your spouse is your agent, getting a divorce or legally separating from your spouse automatically revokes the document (M.G.L. ch.201D §7).
Sample
Below, you can download a Massachusetts health care proxy in PDF & Word format.
