Home > Legal > Legal > Power of Attorney Template > Georgia Power of Attorney Form > Georgia Statutory Durable Power of Attorney For Health Care

Georgia Statutory Durable Power of Attorney For Health Care

At Speedy Template, You can download Georgia Statutory Durable Power of Attorney For Health Care . There are a few ways to find the forms or templates you need. You can choose forms in your state, use search feature to find the related forms. At the end of each page, there is "Download" button for the forms you are looking form if the forms don't display properly on the page, the Word or Excel or PDF files should give you a better reivew of the page.
The Georgia statutory durable power of attorney for health care is a legal document used by the grantor to authorize the attorney-in-fact to make decisions about his/her health care matters.

Georgia Statutory Durable Power of Attorney For Health Care Page 2
Georgia Statutory Durable Power of Attorney For Health Care
2. The powers granted above shall not include the following powers or shall be subject to the following rules or
limitations (here you may include any specific limitations you deem appropriate, such as your own definition of when life-
sustaining or death-delaying measures should be withheld; a direction to continue nourishment and fluids or other life-
sustaining or death-delaying treatment in all events; or instructions to refuse any specific types of treatment that are
inconsistent with your religious beliefs or unacceptable to you for any other reason, such as blood transfusions,
electroconvulsive therapy, or amputation):
THE SUBJECT OF LIFE-SUSTAINING OR DEATH-DELAYING TREATMENT IS OF PARTICULAR IMPORTANCE
FOR YOUR CONVENIENCE IN DEALING WITH THAT SUJECT, SOME GENERAL STATEMENTS CONCERNING
THE WITHHOLDING OR REMOVAL OF LIFE-SUSTAINING OR DEATH-DELAYING TREATMENT ARE SET FORTH
BELOW. IF YOU AGREE WITH ONE OF THESE STATEMENTS, YOU MAY INITIAL THAT STATEMENT, BUT DO
NOT INITIAL MORE THAN ONE.
I do not want my life to be prolonged nor do I want life-sustaining or death-delaying treatment to be provided
or continued if my agent believes the burdens of the treatment outweigh the expected benefits. I want my
agent to consider the relief of suffering, the expense involved, and the quality as well as the possible extension
of my life in making decisions concerning life-sustaining or death-delaying treatment.
Initials
I want my life to be prolonged and I want life-sustaining or death-delaying treatment to be provided or
continued unless I am in a coma, including a persistent vegetative state, which my attending physician
believes to be irreversible, in accordance with reasonable medical standards at the time of reference. If and
when I have suffered such an irreversible coma, I want life-sustaining or death-delaying treatment to be
withheld or discontinued.
Initials
I want my life to be prolonged to the greatest extent possible without regard to my condition, the chances I
have for recovery or the cost of the procedures.
Initials
THIS POWER OF ATTORNEY MAY BE AMENDED OR REVOKED BY YOU AT ANY TIME AND IN ANY MANNER
WHILE YOU ARE ABLE TO DO SO. IN THE ABSENCE OF AN AMENDMENT OR REVOCATION, THE AUTHORITY
GRANTED IN THIS POWER OF ATTORNEY WILL BE EFFECTIVE AT THE TIME THIS POWER IS SIGNED AND
WILL CONTINUE UNTIL YOUR DEATH AND WILL CONTINUE BEYOND YOUR DEATH IF AN ANATOMICAL
GIFT, AUTOPSY, OR DISPOSITION OF REMAINS IS AUTHORIZED, UNLESS A LIMITATION ON THE BEGINNING
DATE OR DURATION IS MADE BY INITIALING AND COMPLETING EITHER OR BOTH OF THE FOLLOWING:
3. (place your initials here) This Power of Attorney shall become effective on _________________________
(a future date or event during your lifetime, such as court determination of your disability, incapacity, or incompetency,
when you want this power to first take effect).
4. (place your initials here) This Power of Attorney shall terminate on
IF YOU WISH TO NAME SUCCESSOR AGENTS, INSERT THE NAMES AND ADDRESSES OF SUCH SUCCESSORS
IN THE FOLLOWING PARAGRAPH:
Georgia Statutory Durable Power of Attorney For Health Care