Nebraska Health Care Power of Attorney Form


A Nebraska health care power of attorney is a form filled out by a person (the grantor) so that another person (the attorney-in-fact) can take care of their medical wishes if they cannot do so for themselves. Medical emergencies, such as car accidents, falls, or concussions, can cause the grantor to become incapacitated. Similarly, terminal illnesses, like cancer, dementia, or Lou Gehrig’s disease, can impact their ability to think clearly and make decisions. In any of these circumstances (in addition to other qualifying injuries or illnesses), the attorney-in-fact becomes responsible for determining the grantor’s medical treatment and care.

The grantor has the option of stating their preferences for life-sustaining treatment, the administering of artificial nutrition and hydration, and/or end-of-life plans in the form. The attorney-in-fact must follow the instructions provided before making decisions for the grantor.

If the grantor wants to change the form or assign a new attorney-in-fact, they must create a new health care power of attorney form. The previous document becomes null as soon as the grantor signs the new one. It also terminates if the grantor has the only copy of the form and destroys it or completes a Nebraska revocation of power of attorney.

An attorney-in-fact may decline the role if they divorce the grantor, move to another state, or become too busy. Similarly, the grantor can choose a new attorney-in-fact if they feel the person is no longer trustworthy or both parties experience conflict. The grantor must also create a new form if the original attorney-in-fact passes away. However, the creator of the document does not need a reason for terminating it.

Laws: §§ 20-401 – 20-416  & §§ 30-3401 – 30-3432

Signing requirements  (§ 20-404(1) & § 30-3404(5)): Signed by the grantor and witnessed by at least two (2) adults or acknowledged before a Notary Public.