Washington Medical Power of Attorney Form [PDF]

Authorize someone to make decisions about your healthcare if you become incapacitated and create the Washington medical power of attorney.

Last update: 26 Mar 2024

Washington Medical Power of Attorney Form [PDF]

The Washington medical power of attorney, or healthcare power of attorney, is a legal document that enables your agent or attorney-in-fact to make healthcare decisions on your behalf in situations where you are not able to make such decisions yourself.

The principal can provide the medical power of attorney rights and limitations and outline their agent’s scope of authority. In this way, the agent will make decisions based on the preferences the principal has provided. 

They can indicate what treatments or medications they want or don’t want to be subjected to in case they become unable to make healthcare decisions.

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

Section 11.125.010 to Section 11.125.903 of the Revised Code of Washington regulates the status of medical power of attorney in Washington.

Sections 11.125.050 and 64.08.100 provide that the principal must sign the medical power of attorney before at least two witnesses or a notary public.

In Washington, the principal can revoke the medical power of attorney by notifying their healthcare provider and their agent about their intention to revoke.

How to Write a Medical Power of Attorney in Washington

To draft a valid medical power of attorney in Washington, you should follow the step-by-step process outlined below.

How to Write a Medical Power of Attorney

#1. Access the Medical Power of Attorney Form

On our website, you can find a ready-to-print Washington medical power of attorney template. All you have to do is follow the guidelines of our document builder and enter basic details about the document. 

The builder will then automatically create the document that you can print and sign.

First, you should enter the following details:

  • Date of issuing the medical power of attorney

  • Full name, mailing address, and contact details of the principal

#2. Appoint a Healthcare Representative

The healthcare representative is the person who will make decisions about your healthcare. The medical power of attorney form should include the full name, mailing address, and contact details of your healthcare representative. 

The healthcare representative is also referred to as the agent or the attorney-in-fact.

When choosing a healthcare representative, you should choose someone you trust, like your spouse, a relative, or a friend. This is important due to the fact that the healthcare representative will have the authority to make important decisions about your healthcare.

#3. Identify an Alternative Healthcare Representative

The alternative healthcare representative is also called the alternative agent, secondary agent, or secondary attorney-in-fact. They should act in case the primary healthcare representative is not able to represent you.

The alternative healthcare representative should fulfill the same requirements as the primary one. 

You can appoint one or more people as your alternative healthcare representatives. The medical power of attorney form should include the full name, mailing address, and contact details of each person you want to appoint as your alternative healthcare representative.

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

After finalizing the document, you should print and sign it before at least two competent witnesses.

The witness cannot be:

  • Home care provider

  • A person related to the principal by blood, marriage, or state-registered domestic partnership

#5. Notarize the Form

As an alternative, you can have the notary public acknowledge your medical power of attorney

The notary public will identify you and acknowledge that you have personally signed the document as a principal. This will add additional authenticity to the document and prevent potential misunderstandings and fraudulent activities.

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