South Dakota Medical Power of Attorney Form [PDF]

Follow our guide on appointing someone to make medical decisions on your behalf by drafting the South Dakota medical power of attorney.

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South Dakota
Customized for South DakotaThis document may be legally binding in South Dakota according to your state specific regulations.
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  • Last reviewed on April 27th
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The South Dakota medical power of attorney, or healthcare power of attorney, is a legal document that enables one person, called the agent or the attorney-in-fact, to represent their principal before a healthcare institution and make decisions about their healthcare.

The principal issues a medical power of attorney when they are in unstable physical or mental health, and there is a possibility that they won’t be able to make their own healthcare decisions. 

However, many people issue this document even if they are in good health so they can outline their healthcare preferences and life-sustaining preferences in case of an accident.

Laws and Legal Requirements for a Medical Power of Attorney in South Dakota

Chapter 59 of the South Dakota Codified Laws regulates the status of the medical power of attorney.

According to Section 59-7-2.1, the principal must sign the medical power of attorney before at least two witnesses or a notary public.

Section 59-7-2 provides that the principal can revoke the power of attorney by issuing the medical power of attorney revocation or by notifying the agent and their healthcare practitioner about their intention to revoke the document.

How to Write a Medical Power of Attorney in South Dakota

In South Dakota, the easiest way to issue a medical power of attorney is by following the steps below:

How to Write a Medical Power of Attorney

#1. Access the Medical Power of Attorney Form

On our website, you will find the medical power of attorney template. You can fill it out easily by following the guidelines provided by our advanced document builder.

All you have to do is answer the questions in the builder, and it will automatically create the medical power of attorney for you.

First, you should provide the date of issuing the medical power of attorney, as well as the principal’s full name, mailing address, and contact details.

#2. Appoint a Healthcare Representative

This is your agent or attorney-in-fact. This is the person who will represent you and make healthcare decisions on your behalf. You should enter their full name, mailing address, and contact details in the medical power of attorney form.

The healthcare representative should be of legal age and have the legal capacity to represent you. Moreover, it should be someone you trust, considering they will have the authority to make important decisions about your healthcare. You can appoint your spouse, a friend, a relative, or another person you trust.

Here, you can also specify the rights and restrictions associated with a medical power of attorney as well as the extent of your agent's power.

#3. Identify an Alternative Healthcare Representative

An alternative healthcare representative is also referred to as the secondary agent or secondary attorney-in-fact. They will represent you only if the primary agent cannot do so

The form should also include the full name, mailing address, and contact details of the alternative healthcare representative.

The alternative healthcare representative should also be an adult with the legal capacity to act. You can appoint one or more people as alternative healthcare representatives.

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

After finalizing the medical power of attorney form, you should print and sign it. You should sign the document before at least two witnesses who are of legal age and have the legal capacity.

Witnesses will confirm that you have personally signed the document, which will confirm the authenticity of the document.

#5. Notarize the Form

Alternatively, you can sign the document before the notary public. The notary public will identify all the parties signing the document and acknowledge the authenticity of the document. 

This will provide additional security for all the parties involved and prevent potential fraudulent activities.

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