New Hampshire Durable Power of Attorney for Health Care Form 2
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INTRODUCTION TO YOUR NEW HAMPSHIRE ADVANCE DIRECTIVE
This packet contains two legal documents that protect your right to refuse medical treatment you
do not want, or to request treatment you do want, in the event you lose the ability to make
1. The New Hampshire Durable Power of Attorney for Health Care lets you name someone
to make decisions about your medical care – including decisions about life support – if you can
no longer speak for yourself. The Durable Power of Attorney for Health Care is especially useful
because it appoints someone to speak for you any time you are unable to make your own medical
decisions, not only at the end of life. It becomes effective when your doctor certifies in writing
that you are unable to make health care decisions.
2. The New Hampshire Declaration is your state’s living will. It lets you state your wishes
about medical care in the event that you become terminally ill or enter a permanently
unconscious state and can no longer make your own medical decisions. Your doctor and one
other physician must personally examine you and certify in writing that you are permanently
unconscious or in a terminal condition.
Caring Connections recommends that you complete both of these documents to best ensure that
you receive the medical care you want when you can no longer speak for yourself.
Note: These documents will be legally binding only if the person completing them is a competent
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