Form Title: Form No. Durable Health Care Power of Attorney* AZAG PBGN4F: Durable Mental Health Care Power of Attorney* AZAG PBGN5F: Power of Attorney Delegating Parental Powers: GNPPOA10F *Indicates forms are courtesy of the Office of …
Power of Attorney Lawyer in Tucson. Before creating or signing a power of attorney, you may want to seek the guidance of an experienced Tucson lawyer at Moore Law. Our attorneys will (1) draft a power of attorney that holds up in court; (2) protect your legal rights; and (3) ensure that all the parties involved fully understand the document.
Power of Attorney– Updated 03/2020 Mark Brnovich 1 of 5 . HEALTH CARE POWER OF ATTORNEY . Instructions and Information. GENERAL INSTRUCTIONS: Use this form if you want to select a person, called an “agent”, to make future health care decisions for you so that if you become too ill or cannot make those decisions for
May 12, 2022 · Prepared forms must be printed and filed with the Clerk of the Superior Court, 110 W. Congress, Tucson, Arizona 85701. The Clerk of the Superior Court has a fee schedule for filing fees that must be paid with the filing of these legal forms and the cost of making copies. The fees are subject to change.
If the Principal does not consent to an Autopsy, he or she should initial or mark the blank line preceding the words “Upon my death I DO NOT consent…”. If the Principal does not object to an Autopsy, he or she should mark or initial the blank line preced ing the second statement.
Locate Section 8 titled “About A Living Will.” If the Principal has signed and attached a Living Will, he or she should initial Choice “A,” then attach the full and completed Living Will. If this is not the case, the Principal must indicate he or she has not signed a Living Will and thus, no such document is attached by initialing Choice “B.”
The second section will also have several blank lines requesting information , however, this will refer to the Agent or Surrogate. That is, the entity who will have Medical Decision Making Powers regarding the Principal’s Health. First, use the “Name” and “Address” lines to declare the Full Name of the Surrogate Agent and record the Surrogate Agent’s Address.
This document’s signing may be verified through one Adult Witness or a Notary Public. Each will have a distinct area beneath the heading “Signature of Witness or Notary Public.” If this document’s signing will be verified by a Witness, the Witness will need to Print and Sign his or her Name. The Date of Signature must be reported on the “Date” line and the Witness’ Address should be entered using the blank lines next to “Address.”
The Principal may elect to give the Surrogate Agent/Representative the power to make this decision. If so, then he or she should mark or initial the third statement.
This is common due to Dementia, Alzheimer’s Disease, or resulting from recent surgery. A medical power of attorney can be canceled at any time by the principal completing a Revocation Form.
A medical power of attorney allows a person to handle someone else’s health care decisions only in the chance that he or she may not be able to think for themselves. The representative may not choose any ‘end of life’ decisions unless the Principal specifically writes in that he or she would like that as an option. If the Principal is consciously able to think for themselves then the representative has no say in their treatment.
If you have determined who your Patient Advocate should be and have decided what initiatives he or she should be able to engage in on your behalf, then locate the “PDF” button or “Adobe PDF” link above to download a copy of the template required. This can be saved to your computer and printed immediately if you access this file with your browser. Ideally, you will have a pdf editor that will enable you to prepare this paperwork for signing by entering information directly onscreen.
The principal can select, depending on the State, up to two (2) or three (3) health care agents to act on their behalf. Due to medical emergencies being able to occur at any time, it’s important to name more than one (1) agent in the document.
Durable (Financial) Power of Attorney – Often times a durable, or financial power of attorney, is authorized at the same time with the agent being the same for both.
Whenever the agent performs their duties under the medical power of attorney they will be required to carry a signed copy or original. By law, medical staff will request for the document to be shown.
The person giving powers is known as the principal and the person receiving powers is known as the agent or attorney in fact.
The name of the form varies from State-to-State. Occasionally, medical power of attorney is combined with a living will and into an ‘ Advance Directive ‘.
If you wish to delegate personal responsibilities or duties, revoke or make living wills, or enter into a marriage contract or to initiate a divorce, a general POA will not work – a special POA will. This document has the signature (or mark) of the principal which is dated. It may also bear the signature of another person who acts under the principal’s directions. For its execution, there should be at least 2 18 years+ witnesses present. The witness is not the trustee/ proxy of the principal.
As per the conditions of the Revised Arizona Statute 14-5104, a guardian or a parent to a minor or an incapacitated individual can delegate authority over the said person using a professionally executed POA for at least 6 months. The powers granted will cover care, property, and custody. The powers granted do not, however, include giving consent to adoption or marriage.