Wyoming Medical Power of Attorney Form [PDF]

The Wyoming medical power of attorney, or healthcare power of attorney, is a legal document that allows the person called the agent or attorney-in-fact to represent another person, called the principal, and make healthcare decisions on their behalf.

The principal is the person issuing the medical power of attorney. They issue this document in situations where they are in a bad mental or physical condition, and there is a possibility that they won’t be able to make healthcare decisions for themselves.

The document usually includes their preferences on what treatment or medication they want or don’t want to receive.

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

Title 35, Chapter 22, Article 4 of the Wyoming Statutes, also called the Wyoming Health Care Decisions Act, is the document that regulates the status of medical power of attorney in Wyoming.

Section 35-22-403(b) provides that the principal must acknowledge their signature before at least two witnesses or a notary public.

Section 35-22-404 provides that the medical power of attorney revocation must be written and dated. After issuing the revocation, the principal must notify their healthcare provider and their agent.

How to Write a Medical Power of Attorney in Wyoming

Here, you can see the step-by-step process of drafting the Wyoming medical power of attorney using our medical power of attorney template.

How to Write a Medical Power of Attorney

#1. Access the Medical Power of Attorney Form

Here, you can find the Wyoming medical power of attorney template. All you have to do is fill it out according to the instructions you get from our advanced legal document builder. The builder will ask you questions related to the power of attorney, and at the end of the process, you will have a ready-to-use document.

#2. Appoint a Healthcare Representative

Here, you should provide the full name, mailing address, and contact details of the person you want to authorize as your healthcare representative and make healthcare decisions on your behalf. The healthcare representative is also referred to as the agent or attorney-in-law.

The healthcare representative must be an adult with the legal capacity to act.

Moreover, it should be someone you can trust, considering that they will have an important role in making your healthcare decisions. Here, you can define the scope of authority that your agent has, as well as include the rights and limitations associated with the medical power of attorney.

#3. Identify an Alternative Healthcare Representative

This is the person who acts only in cases where the primary healthcare representative is not able to represent you. This can happen if they lose their legal capacity, pass away, or become, in some other way, unable to act on your behalf and make healthcare decisions.

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

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

After you have finalized the medical power of attorney form, you should print and sign it in front of at least two witnesses.

A witness cannot be:

The principal's healthcare representative
A healthcare provider or their employee
The operator of the community care facility or their employee
The operator of the residential care facility or their employee

#5. Notarize the Form

Alternatively, you can have the notary public acknowledge your signature. The notary public will identify you and confirm that you have signed the document as the principal. This will additionally confirm the authenticity of the document and prevent potential fraud.