California Medical Power of Attorney Form


A California medical power of attorney authorizes an agent to make health care decisions on behalf of the document’s creator (the principal) when they are incapable of making and communicating their own choices, typically due to a life-changing medical event. As per § 4671, the principal may choose to include additional individual health care instructions. They may also grant authority to the agent to make decisions relating to their care, such as where they will live and providing meals.

Overall, the form allows the principal to do two (2) things:

  1. Name an agent to make health care decisions for themselves when they cannot.
  2. Inform doctors and other health care staff of the principal’s preferences for medical treatment if they cannot share their wishes themselves.

Suppose the primary agent cannot perform their duties, whether due to their death, they cannot be located, or they are not fit for the responsibilities given to them. In that case, the principal can name up to two (2) alternate agents using the form.

Laws: Uniform Health Care Decisions Act

Signing Requirements (§ 4673(3)): A California medical POA must be acknowledged before a Notary Public or signed by a minimum of two (2) witnesses to be considered legally binding and official. Although it’s not technically required, having the document be notarized and signed by witnesses is recommended to increase its validity in the eyes of California law.