A Maine Medical Power of Attorney form is a legal document that allows an individual to appoint someone else to make healthcare decisions on their behalf in the event they become unable to do so. This important form ensures that your medical preferences are honored, even when you cannot communicate them yourself. By designating a trusted person, you can have peace of mind knowing that your healthcare wishes will be respected.
The Maine Medical Power of Attorney form is an essential document for anyone looking to ensure their healthcare wishes are honored in the event they become unable to communicate them. This form allows individuals to appoint a trusted person, often referred to as a healthcare agent or proxy, to make medical decisions on their behalf. It covers a wide range of healthcare choices, from routine medical care to life-sustaining treatments, and can include specific instructions regarding the types of medical interventions one would or would not want. Importantly, the form must be completed with clear and concise language to reflect the individual's preferences accurately. In Maine, this document is not only a tool for personal expression but also serves as a legal instrument that healthcare providers must respect. Understanding the nuances of this form can empower individuals to take control of their medical care, ensuring that their values and wishes guide their treatment, even when they cannot speak for themselves.
Maine Medical Power of Attorney
This Power of Attorney document empowers the person you designate (your "Agent") to make healthcare decisions on your behalf in the event that you become unable to make those decisions yourself. It is governed by the laws of the State of Maine.
To complete this Maine Medical Power of Attorney, please fill in the following information:
Principal's Name (Your Name): _______________________________________________
Principal's Address: _______________________________________________________
Principal's Date of Birth: __________________________________________________
Agent's Name: _____________________________________________________________
Agent's Address: ___________________________________________________________
Agent's Phone Number: ______________________________________________________
Alternate Agent's Name (if primary Agent is unavailable): ________________________
Alternate Agent's Address: _________________________________________________
Alternate Agent's Phone Number: _____________________________________________
By signing below, I authorize the Agent listed above to make decisions regarding my health care, including decisions about medical treatment or withholding or withdrawing treatment, if I am found to be incapable of making these decisions myself. This may include, but is not limited to, decisions regarding admission to or discharge from a healthcare facility, the services of doctors, nurses, and other healthcare professionals, and orders concerning life-sustaining treatments.
I affirm that I have the right to revoke this Maine Medical Power of Attorney at any time when I am of sound mind, by notifying my Agent or my healthcare provider orally or in writing.
Principal's Signatures: ___________________________ Date: _________________
Agent's Signature: _____________________________ Date: _________________
Alternate Agent's Signature (Optional): ______________ Date: ______________
Witness's Name: _________________________________________________________
Witness's Signature: ___________________________ Date: _________________
Witness's Address: ______________________________________________________
This document complies with Maine Revised Statutes, Title 18-C, Article 5, Part 8, which outlines the legal requirements for a Medical Power of Attorney in Maine.
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