eForms Logo

Arkansas Medical Power of Attorney Form

An Arkansas medical power of attorney grants a trusted friend or relative of the principal the power to make medical decisions on their behalf should the principal not have the capacity to do so. This is a useful document to have in place before you have surgery or some other scheduled medical procedure where you will be under anesthesia.
PDF

Updated April 03, 2025

4.8 Stars | 106 Ratings
Downloads: 1,368

“Durable Power of Attorney for Health Care” Definition

“Durable power of attorney for health care” means a written advance directive that identifies an agent who is authorized to make healthcare decisions on behalf of the principal.[2]

“Durable power of attorney for health care” includes without limitation a document appointing a healthcare proxy executed under § 20-17-202;[3]

Statutory Form

No, there is no statutory form but the Arkansas Dept. of Health provides an official version.[4]

Sample

Download: PDF

Sources

  1. Ark. Code § 20-6-103
  2. Ark. Code § 20-6-102(4)(A)
  3. Ark. Code § 20-6-102(4)(B)
  4. www.healthy.arkansas.gov/wp-content/uploads/AppointmentHealthCareAgentForm.pdf