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Need a Medical POA

Started by Nextmother, Nov 22, 2003, 07:24:12 AM

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Nextmother

Hey everyone! The new boards look great!!

I have a friend that needs a medical POA for her hubby. Can anyone point me in the right direction? I have done a general POA from the site for her, but the hubby's doc's say they need something a little more medically specific (sp?).


Thanks!!

Next

Brent

Here: http://www.deltabravo.net/custody/poaform.htm

Nextmother


Brent

> I need something that is more specific.

All you need to do is modify it to include medical info (and you shouldn't really even need to do that).

Forthelittleones


hisliltulip

Hope this helps!




CUSTODIAL POWER OF ATTORNEY FOR MINOR CHILD
     I, xxxxxxxxxxxxx, of 123 ABC Street, Anywhere, MN, this _______ day of _________________, 20___, pursuant to the laws of MN governing the temporary delegation of parental powers by a parent or guardian, willfully and voluntarily appoint xxxxxxxxxxxx as my attorney-in-fact and agent ("Agent"), with lawful authority to temporarily act as guardian, with full parental powers, of my minor child xxxxxxxxx ("Child"). In the event for any reason my first-named Agent cannot serve, I hereby appoint xxxxxxxxxxxxx as my Successor Agent to serve with all the same power and authority granted herein.
SECTION 1:  GENERAL GRANT OF POWERS
     My Agent may act for me and in my name in any way that I could as if I were personally present and exercising such parental power with respect to my Child's personal care, custody, travel, education, medical treatment, hospitalization and health care and to require, withhold, or withdraw any type of medical treatment or procedure, even though my child's death may ensue. My agent shall have the same access to my child's medical, school, or other personal and confidential records that I have, including the right to disclose the contents of those records to third parties.
SECTION 2:  SPECIFIC RESTRICTIONS
     My Agent is specifically prohibited from giving parental consent to the marriage or adoption of my Child.
SECTION 3:  THIRD PARTY RELIANCE
     No Person who relies in good faith on the authority of my Agent under this instrument shall incur any liability to me, my estate or my personal representative. In order to induce third parties to accept my Agent's authority, I hereby indemnify and hold harmless any third party who acts in good faith reliance on my Agent's directions concerning my Child.
SECTION 4: TERMINATION OF CUSTODIAL POWER OF ATTORNEY
     My Agent's powers and authority enumerated herein shall be effective commencing xx/xx/xxxx and shall terminate xx/xx/xxxx.
     IN WITNESS WHEREOF, I have executed this Power of Attorney this _____ day of __________________, 20____.
    LEGAL GUARDIAN:



_____________________________________________
xxxxxxxxxxxxxxxxxxxx

     SUBSCRIBED AND SWORN TO before me this _______ day of _____________________, 20____, by xxxxxxxxxxxxxx.
My Commission Expires:

_______________________________   _____________________________________________
Notary Public
Residing at:__________________________________