Virginia Medical Power of Attorney Form [PDF]

Read our step-by-step guide on how to appoint someone to make healthcare decisions for you by issuing a Virginia medical power of attorney.

Last update: 26 Mar 2024

Virginia Medical Power of Attorney Form [PDF]

The Virginia medical power of attorney, or healthcare power of attorney, is a legal document that grants authority to the agent or the attorney-in-fact to represent the principal 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 old age and wants to authorize someone to be able to make general decisions regarding their healthcare and 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 Virginia

Article 8 of the Code of Virginia, also called the Health Care Decisions Act, regulates the status of medical power of attorney in Virginia.

Section 54.1-2983 provides that the principal must sign the medical power of attorney in the presence of at least two witnesses.

Section 54.1-2985 provides that the principal can revoke the medical power of attorney by verbally notifying your healthcare provider and agent about your decision to revoke the document, by destroying the document, or by issuing a revocation of the medical power of attorney.

How to Write a Medical Power of Attorney in Virginia

To make a valid and effective medical power of attorney, your document must be in line with Virginia state laws and regulations.

The following section provides a comprehensive guide on how to draft a valid and effective medical power of attorney.

How to Write a Medical Power of Attorney

#1. Access the Medical Power of Attorney Form

Here, you can find the medical power of attorney template. Our advanced legal document builder will guide you through the process of drafting the medical power of attorney by asking you the relevant questions about the document and filling out the template for you. 

First, you should provide the basic details, such as the date of issuing the document and the full name, mailing address, and contact details of the principal.

#2. Appoint a Healthcare Representative

In this section, you should provide the full name, mailing address, and contact details of the person you want to authorize to make decisions about your healthcare, called the healthcare representative. The healthcare representative is also called the agent or the attorney-in-fact.

The healthcare representative should be an adult with the legal capacity to act. Moreover, it should be someone you can trust. You can appoint your spouse, a friend, a relative, or another trusted advisor as your healthcare representative. 

At this point, you can also outline the rights and responsibilities of your agents, as well as include the rights and limitations associated with medical power of attorney.  

#3. Identify an Alternative Healthcare Representative

The alternative healthcare representative is the person who acts in case the primary one is not able to represent you. They are also referred to as the alternative agent, alternative attorney-in-fact, or secondary agent.

The alternative agent should fulfill the same requirements as the primary one. You can appoint one or more people as your alternative healthcare representatives.

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

After you finalize your medical power of attorney form, you should print and sign it. You should sign the document before at least two witnesses. Witnesses should be adults with the legal capacity to act.

#5. Notarize the Form

Although it is not required by state law, you should also consider signing your document before the notary public. The notary public will identify you and confirm that you have signed the document as a principal. 

This will additionally confirm the authenticity of the document and prevent potential misunderstandings and fraud.

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