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Statutory Short Form Durable Power of Attorney for Health Care, Georgia |
$25.00 |
| This is a form of the Georgia Statutory Short Form Durable Power of Attorney for Health Care. It allows you to appoint an agent for health care decisions and provides written instructions regarding life-sustaining or death delaying treatment. The form provides the opportunity to include specific instructions for your health care should you become unable to make health care decisions for yourself. Specific instructions may also be included to limit the authority of the agent.
Format: |
Microsoft WordDURABLE POWER OF ATTORNEY FOR HEALTH CARE (Official Code of
DURABLE POWER OF ATTORNEY made this _____ day of ______________, 20__.
1. I, _____________ (insert name and address of principal)
hereby appoint _____________ (insert name and address)
as my attorney in fact (my agent) to act for me and in my name in any way I could act in person to make any and all decisions for me concerning my personal care, medical treatment, hospitalization, and health care and to require, withhold, or withdraw any type of medical treatment or procedure, even though my death may ensue. My agent shall have the same access to my medical records that I have, including the right to disclose the contents to others. My agent shall also have full power to make a disposition of any part or all of my body for medical purposes, authorize an autopsy of my body, and direct the disposition of my remains.
2. The powers granted above shall not include the following powers or shall be subject to the following rules or limitations (here you may include any specific limitations you deem appropriate, such as your own definition of when life-sustaining or death-delaying measures should be withheld; a direction to continue nourishment and fluids or other life-sustaining or death-delaying treatment in all events; or instructions to refuse any specific types of treatment that are inconsistent with your religious beliefs or unacceptable to you for any other reason, such as blood transfusion, electroconvulsive therapy, or amputation):
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This is only a partial view of this document. Statutory Short Form Durable Power of Attorney for Health Care, Georgia is just $25.00 and can be immediately downloaded after purchase. |
