Hawaii Medical Power of Attorney Form [PDF]

Discover the importance of the medical power of attorney in the Hawaii healthcare system and use our medical power of attorney template.

Last update: 27 Mar 2024

Hawaii Medical Power of Attorney Form [PDF]

The Hawaii power of attorney, or healthcare power of attorney, is a legal document issued by the principal that grants authority to the attorney-in-fact or the agent to represent them and make decisions about their healthcare in case the principal is unable to do so.

The principal should issue a medical power of attorney if they are diagnosed with a terminal illness or are facing a life-threatening medical procedure. 

However, even if they are not facing these, many parties still choose to draft a medical power of attorney and authorize someone to make decisions about their general medical care.

Laws and Legal Requirements for a Medical Power of Attorney in Hawaii

Laws and Legal Requirements

Title 19, Health Section 327E, of the Hawaii Statutes, also called the Uniform Health-Care Decisions Act, regulates the status of medical power of attorney in Hawaii.

According to §327E-3, the principal and at least two witnesses must sign the medical power of attorney. The witnesses must be at least 18 years old to sign the document. The notary public should also authenticate the signatures of the principals and witnesses.

If you wish to revoke your medical power of attorney, §327E-4 provides that you can inform your physician to change or revoke it.

How to Write a Medical Power of Attorney in Hawaii

To make a valid and effective medical power of attorney, your document must be in line with Hawaii state laws and regulations. The following section provides a step-by-step guide on how to make a valid and effective medical power of attorney.

How to Write a Medical Power of Attorney

#1. Access the Medical Power of Attorney Form

Here, you can find the medical power of attorney form, which will include all the information that should be provided for the power of attorney to be effective and valid.

Right after opening our legal document builder and accessing the medical power of attorney template, you should enter the basic details, such as your full name and mailing address, contact details, and date of issuing the power of attorney.

#2. Appoint a Healthcare Representative

In this section, you should provide the following information about your attorney-in-fact:

  • Their full name

  • Their mailing address

  • Their contact details

When appointing an agent who will represent you in this matter, you should choose someone who is of legal age and has the legal capacity to make decisions

Moreover, you should choose someone who is reliable and trustworthy. Here, you can also include medical power of attorney rights and limitations that will define your agent's scope of authority.

#3. Identify an Alternative Healthcare Representative

The alternative healthcare representative, or secondary agent, is a person who can represent you as your agent only in case the primary agent becomes incapacitated or, in some other way, unable to represent you.

The secondary agent should fulfill the same requirements as your primary agent. You can appoint one, two, or more people as your secondary agents.

#4. Identify the Witnesses and Have Them Sign the Form

After finalizing the medical power of attorney form, you should find at least two witnesses who will sign the document. Witnesses must be of legal age and have legal capacity. They will confirm your identity and confirm that you have signed the document.

#5. Notarize the Form

According to Hawaii state law, the principal and witnesses should sign the medical power of attorney before the notary public. This will additionally confirm the authenticity of the document and prevent potential fraud.

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