Arkansas Medical Power of Attorney Form

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An Arkansas medical power of attorney designates a trusted person (the agent) with the responsibility of communicating a person’s healthcare wishes to doctors and other medical professionals. The form is completed by the person assigning power (the principal). The form, being durable, will remain in effect unless the expiration date has been reached (if any), the principal manually revokes it, the principal is able to make their own decisions again, or a new POA has been completed.



The form is commonly used in situations where:

  • A person will be heading into surgery (and thus unable to speak for themselves);
  • The principal was recently diagnosed with a condition that will eventually leave them incapacitated; or
  • The principal wants a plan in place should an unexpected medical emergency occur.

Laws: § 20-6-1031 – § 20-6-117

Signing requirements (§ 20-6-103): Notarized OR witnessed by two (2) witnesses.