Vermont Medical Power of Attorney Form [PDF]

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

Last update: 26 Mar 2024

Vermont Medical Power of Attorney Form [PDF]

The Vermont power of attorney, or healthcare power of attorney, is a legal document that gives your agent or the attorney-in-fact the authority to represent you and make healthcare decisions on your behalf in situations where you cannot make healthcare decisions yourself.

The principal is responsible for issuing the medical power of attorney. The principal issues the document 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 in the future. 

However, many parties also issue medical power of attorney when they are in good health.

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

Title 18, Chapter 231 of the Vermont Statutes regulates the status of medical power of attorney in Vermont.

According to Section 9703, the principal must sign the medical power of attorney in the presence of at least two witnesses.

Section 9704 provides that the principal can revoke the medical power of attorney by issuing the medical power of attorney revocation. After issuing the revocation, the principal should notify their doctor and agent.

How to Write a Medical Power of Attorney in Vermont

In Vermont, 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

Here, you will find the California medical power of attorney template. You have to fill it out with the relevant information according to your preferences regarding the medical treatment you want or don’t want to be subjected to. 

Our advanced document builder will provide you with the relevant information for every section of the document you are filling out.

#2. Appoint a Healthcare Representative

This section should include the basic details about the person you want to authorize to make healthcare decisions on your behalf. This includes their full name, mailing address, and contact details. The healthcare representative is also referred to as the agent or the attorney-in-fact.

The healthcare representative should be an adult with the legal capacity to act, and it should be someone you trust. You can appoint your spouse, a friend, a relative, or another trusted individual. You can specify the rights and restrictions of a medical power of attorney in this section, 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 a secondary agent or secondary attorney-in-fact. You should appoint an alternative healthcare representative in case the primary healthcare representative passes away, loses legal capacity, or becomes unable to represent you in some other way.

The alternative healthcare representative should fulfill the same requirements as the primary healthcare representative. You can appoint one or more people as your 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. The state law provides that in order for the document to be valid and effective, you must sign it before at least two witnesses.

Witnesses must be at least 18 years old and have the legal capacity to act. The principal's agent, spouse, parent, adult sibling, adult child, or adult grandchild cannot serve as witnesses. By signing the document, witnesses will confirm that you have personally and freely signed the medical power of attorney.

#5. Notarize the Form

You can also request that the notary public acknowledge both your signature and the signatures of your witnesses, even though state law does not expressly require it. This will provide additional security for all the parties involved and prevent potential fraudulent activities.

Sign Up for Our Newsletter

Newest legal practices, savvy tips and insightful articles.