Connecticut Medical Power of Attorney Form

A Connecticut Medical Power of Attorney, otherwise known as the “Appointment of Health Care Representative,” is suitable for those who would like to grant a third party the authority to make healthcare decisions on their behalf in the event of their incapacitation. It merely requires the principal to supply it with the name of their appointee(s), the date, and their signature.

Last updated October 23rd, 2024

Laws

Statutes – Chapter 368w: Removal of Life Support Systems and Medical Orders for Life-Sustaining Treatment (§ 19a-570 – § 19a-580i)

Definitions – “Health care representative” means the individual appointed by a declarant pursuant to an appointment of health care representative for the purpose of making health care decisions on behalf of the declarant (§ 19a-570(6)).

Signing Requirements – Signatures to certify the event must be recorded by two (2) suitable witnesses (§ 19a-576). Although not obligated by law, notarization of the document is highly recommended (§ 19a-578).

Revocation – § 19a-575a(b-e)