The New York Medical Power of Attorney or “health care proxy” delivers an official nomination to an alternate party to gain authority to make decisions related to the health care treatment of a declaring individual. The instituted agency granted to the attorney-in-fact allows medical professionals to legally take instruction from someone other than the patient in cases where they may be unable to speak for themselves. Preparing the provided document is generally a preconceived arrangement put into place should the possibility of incapacitation arise.
Instructions/Information: Adobe PDF
Laws
Definition – “Health care proxy” means a document delegating the authority to make health care decisions, executed in accordance with the requirements of this article (§ 29C-2980(8)).
Signing Requirements – Two (2) witnesses must serve to review and substantiate the act of endorsement to authenticate the event (§ 29C-2981.2).
Revocation – § 29C-2985
Other Versions (5)
- Archdiocese of NY
- Compassion and Support NY
- eForms Version
- New York State Senate Version
- Rochester Regional Health
Archdiocese of New York Version (also available in Spanish/en Español)
Download: Adobe PDF
Compassion and Support New York Version (also available in Spanish/en Español)
Download: Adobe PDF
Download: Adobe PDF, MS Word (.docx)
Download: Adobe PDF
Instructions: Adobe PDF
Rochester Regional Health Version
Download: Adobe PDF
Additional Resources
- Caring Kind – Legal Planning
- Freedom Care – A Health Care Proxy Guide for New York
- Law Help NY – Health Care Proxies and Living Wills
- New York Attorney General – Planning Your Health Care in Advance
- New York Department of Health – Advance Care Planning
- New York Department of Health – DNR and MOLST
- New York Life – Health Care Power of Attorney
- New York State Bar Association – Living Wills and Health Care Proxies Brochure
- Rochester Regional Health – Advance Directives (Living Will) and Healthcare Proxy
- SeniorLaw.com – FAQs Concerning Living Wills and Health Care Proxies
Related Forms (5)
- Advance Directive
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- MOLST Form
- Nonhospital Order Not to Resuscitate (DNR Order)
Advance Directive (Medical POA & Living Will)
Download: Adobe PDF
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Medical Orders for Life-Sustaining Treatment (MOLST)
Download: Adobe PDF
Instructions: Adobe PDF
Nonhospital Order Not to Resuscitate (DNR Order) (also available in Spanish/en Español)
Download: Adobe PDF