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General Medical Power of Attorney Form 1

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This form, not specific to any state, can be used in most states in the United States, except Indiana, New Hampshire, Ohio, Texas and Wisconsin.

General Medical Power of Attorney Form 1 Page 2
General Medical Power of Attorney Form 1
This publication was produced by the Commission on Law and Aging, American Bar Association.
The mission of the ABA Commission on Law and Aging is to strengthen and secure the legal rights,
dignity, autonomy, quality of life, and quality of care of elders. It carries out this mission through
research, policy development, technical assistance, advocacy, education, and training. This
publication provides information and tools individuals may use in preparing their own health care
power of attorney. See: www.americanbar.org/aging
The ABA gratefully acknowledges the Archstone Foundation and the California HealthCare
Foundation for their funding of this publication. See:
www.Archstone.org
www.CHCF.org
Copyright © 2011 by the American Bar Association
Points of view or opinions in this publication do not represent the official policies or positions of the American
Bar Association unless adopted according to the bylaws of the Association.
This publication does not give legal advice and it does not substitute for an attorney, nor does it try to answer all
questions about all situations you may encounter. If you need legal advice or other expert assistance, seek the
services of an attorney or another competent professional person.
This booklet is intended for educational and informational purposes only. You must not reproduce it by any
means for commercial purposes unless you receive written permission from the American Bar Association.
General Medical Power of Attorney Form 1
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