Arizona Health Care Power of Attorney Form

Arizona Health Care Power of Attorney Form

An Arizona health care power of attorney is a legally binding document that allows a principal to establish a trusted friend or family member as their medical “agent.” The agent is responsible for communicating with medical professionals regarding the principal’s treatment should they be unable to do so independently. This form is durable, meaning that a principal can assign an agent to take care of funeral arrangements and after-life wishes if they pass away (§ 36.3221). The agent is legally bound to the terms listed in Part 4 of the form, making them liable for any choices that do not align with the principal’s requests. However, if the agent made decisions in good faith, then they are not responsible.

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Before signing, the principal should discuss this form with the agent, doctors, lawyers, and/or clergypersons. By reviewing the document, the principal ensures that all parties agree on their medical wishes.

By signing, the principal is allowing the agent to make decisions regarding:

  • Allow or deny medical treatment (e.g., diagnosing, surgery, therapy, etc.);
  • Authorize care from providers (i.e., doctors, nurses, therapists) and pay for them using principal’s financial resources or estate;
  • Approve or refuse admittance to health care facilities, nursing homes, or assisted living communities. The agent can make mental health care decisions for the principal using this form unless it is for inpatient psychiatric care (24-hour-a-day supervision) or intensive treatment; and/or
  • Medical record access and ongoing communication with health care providers regarding their history.

Laws: Title 36, Chapter 32

Signing requirements (§ 36-3282(A)(5)): The form needs to be notarized OR witnessed by at least one (1) person.