R.S. 2. To authorize any and all medical and dental care for the health and well being of the medical and dental exams and tests x-rays surgeries anesthesia and hospital care. This Special Power of Attorney does not give the Attorney in Fact the power to consent to the marriage or adoption of the child or incapacitated person. earlier by the parent or guardian in writing. DELEGATION OF POWER BY PARENT OR GUARDIAN PURSUANT TO 15-14-105 C. R.S. I full name parent or guardian of the minor child...
temporary medical power form

Get the free temporary medical power form

Fill form: Try Risk Free
  • Get Form
  • eSign
  • Fax
  • Email
  • Add Annotation
  • Share

This Power of Attorney is a form which provides for the appointment of an attorney-in-fact for the care of a child or children, including health care.

This Power of Attorney form requires that the signature of the person giving another the power of attorney to be notarized.

Video instructions and help with filling out and completing temporary medical power form

Welcome to the Cleveland Clinic thank you for allowing us the honor of participating in your care you're going to be faced with some important decisions regarding your stay your hospitalization and upcoming procedure we want to help patients and their families better understand ways in which they can partner with their healthcare team we'd like to make you and your family comfortable with a very important topic the healthcare power of attorney the durable healthcare power of attorney helps us better understand patient wishes in a time when they may not be able to communicate for themselves it's beneficial on on all fronts because as the healthcare team we can provide you with what you desire the healthcare power of attorney allows you to authorize someone you trust to speak for your medical wishes if you're under anesthesia if you're on medication and can't consent to a procedure who do we talk to who do we call whoever you appointed us you have a care power of attorney we'll help the medical team with those decisions it really hit home you know these are things that I would like some people have misconceptions about the healthcare power of attorney the document is only for medical authorizations it does not give any kind of financial rights or financial obligations I believe everyone should have a healthcare power of attorney once they turn 18 because anything can happen at any time people sometimes wonder who they should name is their agent you can name any adult to be your medical power of attorney these documents that guard your medical wishes are especially important if you want to name someone who is not a relative if you are in any kind of civil union or if the person you trust most in the world is your next-door neighbor or your best friend of 50 years or your partner that person is not going to have any legal say in your medical care when you have a document everybody's more comfortable it's more clear and I tell them the family members it's not you making this big decision the patient has made the decision already if you don't have a health care power of attorney on file with us and you need medical care and cannot give consent yourself Ohio law recognizes an order of decision-makers the default is the Guardian first than your spouse then your adult children and if you have more than one it would require a majority of your adult children to agree after your children it would be your parents after your parents it would be a majority of your siblings you are doing your family a favor by having the healthcare power of attorney in place I always encourage people to have the conversation to talk to people about your decisions any instruction you give to your loved ones is going to be a real guiding light to them in moments when you actually need medical care there are four pieces that are required to make it a legal document the first is your name and birthdate on the front the second is the name and telephone number of anybody you want to...