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Alabama Durable Health Care Power of Attorney Form

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The Alabama durable health care power of attorney is a legal document used by the grantor to authorize the attorney-in-fact to make decisions about his/her health care matters.

Alabama Durable Health Care Power of Attorney Form Page 2
Alabama Durable Health Care Power of Attorney Form
To contract for health care or related services, without the agent incurring personal liability
therefore;
To hire and fire medical, social service or related personnel responsible for my care;
To authorize or refuse to authorize any medication or procedure to relieve pain, even though
such use may lead to temporary discomfort or addiction, or inadvertently hasten the moment of
death;
To make anatomical gifts of part of all of my body for medical purposes,
To authorize an autopsy and direct disposition of my remains, to the extent permitted by law,
and
To take any other action necessary to effectuate the intent and purpose of this broad grant of
powers, including, without limitation, granting any waiver of release from liability required by
any health care provider or related agency, and
To sign any document relative to health care in any way whatsoever and pursuing legal action
in my name at the expense of my estate, should that be necessary to enforce compliance with
my wishes as determined by my agent pursuant to the authority given herein.
Without in any way limiting the broad powers herein granted, I express the hope that, circumstances
permitting, my agent will consult family and friends for their advice and support in arriving at what
may be difficult decisions; but the final decisions shall be that of my agent.
No person who relies in good faith upon any representation of my agent or successor agent shall be
liable to me, my estate, my heirs or assignees, for recognizing the agent’s authority. Although no
compensation of my agent is contemplated, (s)he shall be entitled to reimbursement of any and all
reasonable expenses incurred as a result of carrying out any provision of this document.
Invalidity of one or more powers shall not invalidate any others.
I am in full control of my mental faculties and I understand the contents of this document and the
effect of this grant of powers to my agent.
Dated this _____ day of ______________, 201__.
_________________________
,Grantor
WITNESSES
I believe the Grantor to be of sound mind and able to make decisions of this kind. I did not sign
his/her name and I am not the health care agent. I am not related to the Grantor by blood, adoption or
marriage, and not entitled to any part of his/her estate. I am at least 19 years old and am not directly
responsible for his/her medical care or expenses.
_________________________
Signature of Witness
_________________________
Name of Witness
Untitled Document http://www.law.ua.edu/elderlaw/advance/7print.asp
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Alabama Durable Health Care Power of Attorney Form