Tennessee Medical Power of Attorney Form

A Tennessee medical power of attorney lets you choose someone you trust to make medical decisions on your behalf if you cannot communicate due to illness. The person you choose is called your agent or attorney-in-fact. In Tennessee, a medical POA is known as a durable power of attorney for health care.

) The durable power of attorney for health care must be in writing and signed by the principal. The durable power of attorney for health care is valid if the principal’s signature is either attested by a notary public with no witnesses or witnessed by two (2) witnesses without attestation by a notary public. A witness is a competent adult, who is not the agent, and at least one (1) of whom is not related to the principal by blood, marriage, or adoption and would not be entitled to any portion of the estate of the principal upon the death of the principal under any will or codicil made by the principal existing at the time of execution of the durable power of attorney for health care or by operation of law then existing. The durable power of attorney for health care shall contain an attestation clause that attests to the witnesses’ compliance with the requirements of this subdivision (a)(3). It is the intent of the general assembly that this subdivision (a)(3) have retroactive application.

Laws

• Statute: Tenn. Code Title 34, Chapter 6, Part 2
• Signing Requirements: Two witnesses or a notary public (§ 34-6-203).
  • The witnesses must not be related to the principal by marriage, adoption, or blood. They also shouldn’t receive any part of the principal’s estate when they pass away.
• Revocation: The principal can inform the agent that they’re canceling their authority either verbally or in writing. They can also revoke the agent’s authority by telling the health care provider.
  • If the principal’s marriage ends, any previous authority the spouse has as a health care agent is automatically canceled. (§ 34-6-207)

Sample