Free Massachusetts Medical Power of Attorney Form | PDF

Massachusetts Medical Power of Attorney Form

Massachusetts Medical Power of Attorney, better known as the “Health Care Proxy,” is the appointment of an agent to handle medical decisions on behalf of another. The purpose of executing this document is to ensure that you are cared for by a person of trust in the event of your incapacitation (the inability to function and vocalize your wishes).

Last updated October 23rd, 2024

Massachusetts Medical Power of Attorney, better known as the “Health Care Proxy,” is the appointment of an agent to handle medical decisions on behalf of another. The purpose of executing this document is to ensure that you are cared for by a person of trust in the event of your incapacitation (the inability to function and vocalize your wishes).

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Other Versions (5)

Baystate Health Version

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Central Mass. Partnership to Improve Care at the End of Life Version

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Dana-Farber Cancer Institute Version

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Honoring Choices Massachusetts Version

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Massachusetts Medical Society Version

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Multilingual Versions (9)

Albanian Version

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Arabic Version

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Haitian Creole Version

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Khmer Version

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Portuguese Version

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Russian Version

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Spanish/Español Version

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Traditional Chinese Version

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Vietnamese Version

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Additional Resources

Related Forms

Advance Directive (Medical POA & Living Will)

Download: Adobe PDF

 

 

 


Comfort Care DNR Order Verification with Bracelet Inserts

Download: Adobe PDF

 

 

 


Durable (Financial) Power of Attorney

Download: Adobe PDF, MS Word (.docx)

 

 

 


Medical Orders for Life-Sustaining Treatment (MOLST) Form

Download: Adobe PDF, MS Word (.docx)
Information: Adobe PDF

 

 

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