Ohio Medical Power of Attorney Form [PDF]

Discover the importance of the medical power of attorney in Ohio's healthcare system by creating the Ohio medical power of attorney.

Last update: 27 Mar 2024

Ohio Medical Power of Attorney Form [PDF]

The Ohio medical power of attorney, or healthcare power of attorney, is a legal document that one party, called the principal, uses to authorize another party, called the agent or attorney-in-fact, to represent them and make healthcare decisions on their behalf.

The healthcare power of attorney should be issued in the following situations:

When to Issue a Healthcare Power of Attorney

  • If the principal is of unstable health and wants to authorize someone to be able to make general decisions regarding their healthcare treatment

  • If the principal is diagnosed with a terminal condition

  • If the principal is facing a possible surgery

  • If the principal wants to authorize someone to make end-of-life decisions on their behalf

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

Laws and Legal Requirements

Sections 1337.11 to 1337.17 of the Ohio Revised Code determine the status of medical power of attorney in Ohio.

Section 1337.12 provides that the Ohio medical power of attorney must be signed before at least two witnesses or a notary public.

Section 1337.14 provides that the principal can revoke the medical power of attorney at any time by creating a medical POA revocation or notifying the attending physician about their intention to revoke the document.

How to Write a Medical Power of Attorney in Ohio

To make a valid and effective medical power of attorney that’s in line with Ohio state laws and regulations, you should follow the steps outlined in the section below:

How to Write a Medical Power of Attorney

#1. Access the Medical Power of Attorney Form

On our website, you can find the Ohio medical power of attorney template. All you have to do is provide the relevant information and fill it out accordingly. Our advanced legal document builder will guide you through each step of the fill-out process.

First, you should provide 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 is authorized to make healthcare decisions on your behalf according to your medical power of attorney rights and limitations.

Here is where you should give their complete name, mailing address, and phone number.  

Moreover, you should choose someone you trust, considering the importance of the matter. You can appoint your spouse, a blood relative, a friend, or another trusted advisor.

#3. Identify an Alternative Healthcare Representative

This is the person who will act on your behalf and make healthcare decisions in case the primary agent is not willing or able to represent you

You can name one, two, or more people as alternative agents by entering their full names, mailing addresses, and contact details. The substitute agent ought to satisfy the identical prerequisites as the principal agent.

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

The Ohio state law provides that the principal must sign the medical power of attorney form before at least two witnesses. 

The following parties are not eligible to be witnesses:

  • A person who is related to the principal by blood, marriage, or adoption

  • The principal's healthcare representative or alternative healthcare representative

  • The principal’s attending physician or the administrator of any nursing home in which the principal is receiving care

#5. Notarize the Form

Alternatively, you can sign the medical POA before a notary public. They will identify the principal and confirm that the principal has personally signed the medical power of attorney. This will additionally confirm the document's authenticity and prevent any fraudulent activities.

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