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Idaho Medical Power of Attorney Form & Living Will

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In Idaho, a person may fill out a living will and durable power of attorney for health care, which confers authority to a trusted friend or relative pursuant to Idaho Statutes Title 39, Chapter 45, to make health care decisions on his or her behalf in the event the person can not make decisions for themselves. With this form you can also specify your treatment preferences if you desire so that your agent is aware of your desires.

Durable Power of Attorney – A legal document used to enable the Principal to elect an agent to take care of their finances when it becomes impossible to do so themselves.

Definition – § 39-4502(8)

LawsTitle 39, Chapter 45 (The Medical Consent and Natural Death Act)

Registration – If the principal, after completing the power of attorney document, would like to have it registered with the State of Idaho (at no cost) they may do so by completing the Registration Form and sending to Idaho Secretary of State Attn: Health Care Directive Registrar 700 West Jefferson, Room E205 PO Box 83720 Boise, ID 83720-0080.

How to Write

1 – Open or Download The Needed Form

The Living Will/Durable Power of Attorney is accessible directly on this page through the buttons provided. Depending on your needs, you may open or download it as a PDF, ODT, or Word file.

2 – Naming The Principal And The Health Care Agent

The individual who intends to designate a Health Care Agent to carry out Health Care decisions on his or her behalf must enter his or her Name on the first blank line under the heading “Designation of Health Care Agent.”

Directly below the words “do hereby designate and appoint,” report the Full Name, Complete Address, and Current Telephone Number of the person whom the Principal is designating as his or her Health Care Agent.

3 – Review This Document’s Powers Then Declare The Principal’s Intentions

The decision making powers the Principal empowers the named Health Care Agent are generally broad and will be defined in this form. The Principal should read this form and decide whether any special considerations, limitations/restrictions, extensions, and/or additional powers should be applied to the Health Care Agent’s decision making authority. If there are any such items, they must be reported as per section “4. Statement of Desires, Special Provisions, and Limitations.” Several blank lines have been provided specifically for this purpose, however, if this is not enough room, you may cite an attachment.

4 – If An Alternate Health Care Agent Is To Be Granted Power

The Principal may choose to have one or two individuals ready to assume the Primary Health Care Agent’s Decision Making Authority and Powers should the Primary Health Care Agent be unreachable, unable to, or unwilling to assume the Authority of the Health Care Agent role. Report the Full Name and Complete Address of each Alternate Health Care Agent the Principal wishes to grant this role to. There will be enough room to report on two individuals. If the Principal desires more, this may be documented in an attachment.

5 – The Principal’s Verifying Signature

In order for the Principal’s Authority in Health Care Decisions to be properly appointed to the Health Care Agent, he or she must sign this form after it has been filled out and any required attachments made.

The Date this Health Care Authority is being signed must be reported using the three spaces provided in the “Date and Signature of Principal” setting.

The Principal, issuing this Authority, must sign his or her Name on the blank line labeled “You sign here.”

The Principal’s Signature will also need to be verified. This may be done through the Signatures of two Witnesses who has observed this Principal Action. Each Witness should locate and read the selection under the heading, “Statement of Witnesses.” When finished he or she must Sign the “Signature” line, Print his or her Name on the “Print Name” line, provide his or her Address, then enter the Date of Signature.

The statement below must be signed by at least one of the Signature Witnesses. This statement may only be signed by a Witness who is not related to the Principal in any way or entitled to any kind of property or money upon the death of the Principal.

The Notary Public viewing this signing will supply his or her credentials and verification to successfully notarize this document.


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