Louisiana Medical Power of Attorney Form [PDF]

The Louisiana medical power of attorney, or healthcare power of attorney, is a legal document that authorizes your agent to make healthcare decisions on your behalf in case you cannot make healthcare decisions yourself. This can happen if the principal is diagnosed with a terminal illness or is about to have serious surgery.

The medical power of attorney can include various instructions about the principal’s healthcare preferences. They can indicate what treatments or medications they want or don’t want to be subjected to. They can also set their preferences in terms of autopsy or organ donation in case they pass away.

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

Laws and Legal Requirements

Title 40, Section 1151 of the Louisiana Revised Statutes regulates the status of medical power of attorney in Louisiana.

§ 40:1151.2 provides that the principal should sign the medical power of attorney in front of two witnesses. If the principal is unable to make a written statement due to a terminal and irreversible condition, the principal should make a verbal statement before at least two witnesses.

§40:1151.3 provides that the principal can revoke the Louisiana medical power of attorney at any time, regardless of their legal capacity.

How to Write a Medical Power of Attorney in Louisiana

Here, you can see the step-by-step process of writing the Louisiana medical power of attorney using our medical power of attorney template.

How to Write a Medical Power of Attorney

#1. Access the Medical Power of Attorney Form

Here, you will find the Louisiana medical power of attorney template. You must fill it out with the relevant information according to your medical preferences.

Our advanced document builder will guide you through the whole process by indicating how each field in the medical power of attorney form should be filled out.

In the first section, you should provide the basic details, such as the principal’s full name, mailing address, contact details, and date of issuing the medical power of attorney.

#2. Appoint a Healthcare Representative

This is a person that you want to authorize to represent your interests and make medical decisions on your behalf. This person is also called the agent or the attorney-in-fact. Your agent should be an adult with the legal capacity to act.

In this section, you should enter the following:

Your agent’s full name
Your agent’s mailing address
Your agent’s contact details

Here, you can also provide medical power of attorney rights and limitations and define what authorities your agent should have.

#3. Identify an Alternative Healthcare Representative

The alternative healthcare representative is also called the secondary agent. This is a person who will represent you in case your primary agent becomes incapacitated or is unable to represent you.

The secondary agent should also be an adult with the legal capacity to act. You can appoint one, two, or more people as your secondary agents.

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

After filling out the medical power of attorney form, you should print and sign it. Louisiana law provides that the document must be signed before at least two witnesses. Witnesses should be adults with legal capacity.

#5. Notarize the Form

Although state law doesn’t explicitly require medical power of attorney to be notarized, if you are able to do so, you should consider having your document acknowledged by the notary public. This will provide security for all the parties involved and prevent potential fraud.