New Jersey Medical Power of Attorney Form [PDF]

Authorize someone to make decisions about your healthcare by drafting the New Jersey medical power of attorney using our template.

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New Jersey
Customized for New JerseyThis document may be legally binding in New Jersey according to your state specific regulations.
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  • Last reviewed on April 27th
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The New Jersey power of attorney, or healthcare power of attorney, is a legal document that delegates the authority for making healthcare decisions from one person, called the principal, to another person, called the agent or the attorney-in-fact.

The principal usually issues the medical power of attorney if they have been diagnosed with a terminal illness or are facing a complicated surgery.

However, many parties also create the medical power of attorney for general purposes if they are of unstable physical or mental health, and there is a possibility that they might become incapable of making their own healthcare decisions.

Laws and Legal Requirements for a Medical Power of Attorney in New Jersey

Laws and Legal Requirements

Title 26, Sections 2H-53 to 2H-67 of the New Jersey Revised Statutes regulate the status of the medical power of attorney form in New Jersey.

Section 26:2H-56 provides that the medical power of attorney must be signed before at least two witnesses or a notary public.

Section 26: 2H-57 provides that the principal can revoke the medical power of attorney by:

  • Completing the POA revocation form

  • Notifying their attending physician about the revocation

  • Issuing a new medical POA

  • Taking any other action that evidences an intent to revoke the medical POA

How to Write a Medical Power of Attorney in New Jersey

To draft a valid medical power of attorney in New Jersey, follow the step-by-step process outlined below.

How to Write a Medical Power of Attorney

#1. Access the Medical Power of Attorney Form

Here, you will find the New Jersey medical power of attorney template. You have to fill it out with the relevant information and indicate your preferences about your healthcare treatment. 

Our advanced legal document builder will provide you with instructions on how to fill out each of the sections of the document.

First, you should enter the date of issuing the medical power of attorney and the principal's full name, mailing address, and contact details.

#2. Appoint a Healthcare Representative

The healthcare representative is also called the agent or the attorney-in-fact. This is the person who will have the authority to make decisions about your healthcare on your behalf. Here, you should enter their full name, mailing address, and contact details.

The agent should be an adult with the legal capacity to act. Moreover, they should be trustworthy, considering the importance of their authority. You can name your spouse, a blood relative, a friend, or another trustworthy advisor as your agent. 

Here, you can also include all the medical power of attorney rights and limitations and outline your agent’s scope of authority.

#3. Identify an Alternative Healthcare Representative

This person is also called the secondary attorney-in-fact or a secondary agent. They act and make decisions about your healthcare in case your primary agent becomes incapacitated or becomes, in some way, unable to represent you.

Here, you should enter their full name, mailing address, and contact details. You can name one or more people to act as your secondary agents.

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

After finalizing your medical power of attorney form, you should print and sign it. The document should be signed by at least two witnesses. Both witnesses should be of legal age and have the legal capacity to act. They will confirm that the principal has personally signed the document.

#5. Notarize the Form

Alternatively, instead of providing witness signatures, you can sign your medical power of attorney before a notary public. They will confirm your identity and acknowledge that you have personally signed the document. This will increase the authenticity of the document and prevent potential misunderstandings and fraudulent activities.

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