California Medical Power of Attorney Form

The California Medical (Health Care) Power of Attorney authorizes an agent to make health care decisions on behalf of the creator of the document (who is referred to as the principal) when they are incapable of making and communicating their own decisions, 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 personal 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 the preferences for how the principal would prefer to be treated in the event they are unable to share their wishes themselves.

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


State Laws & Signing Requirements

Laws: Uniform Health Care Decisions Act (§§ 4670 to 4743)

Signing Requirements (§ 4673(3)): A California Medical (Health Care) POA must be acknowledged before a Notary Public or signed by a minimum of two (2) witnesses in order 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.


Sample Template