This Alabama Durable Health Care Power of Attorney Form is used to assign someone the power to take decisions on your behalf in case you are unable to take a decision. This document is to be used as a complementary or supplementary form in conjunction with any other Advance Health Care Directive and/ or Durable Power of Attorney for financial matters drawn out by you in the past.
How to fill this Alabama Durable Health Care Power of Attorney Form:
- This form is applicable only in the state of Alabama and the counties that fall under it’s jurisdiction.
- In The first paragraph you need to enter the following details:
- Your Full Legal Name.
- Your Current address of residence.
- City and County of Residence.
- The name of the person whom you are appointing as your power of Attorney.
- The address of the person assigned the Power of Attorney.
- In case your first appointed person cannot or does not want to make health care and other related personal decisions on your behalf, you can assign a second person to take the same decisions.
- Full legal name of the Second person assigned the Power of Attorney.
- His full address.
- The second paragraph contains the declaration that states the following points.
- Using this document you intend to create a durable power of attorney, for any period of incapacity when you are unable to make any healthcare related decisions.
- This Durable power of attorney will be used in conjunction with any other Durable power of attorney for financial matter that you have have drawn in the past or will in the future while this agreement remains active.
- You agree that you want to receive proper medical care as long as there is reasonable hope of recover.
- You also want it to be known that you do not want to artificially extend your life beyond any reasonable hope of recovery.
- This document however is not intended to authorize or request euthanasia.
- The next paragraph contains the terms for the Power of Attorney:
- The agent has full power to make decisions on your behalf.
- The agent must communicate with you regarding your wishes if you are able to communicate in any way.
- If you are unable to communicate then the agent has to take a decision based on what you would have chosen if you were able to do so.
- The agent can hire or fire medical or social services personnel responsible for your care.
- The agent is entitled to any reimbursement of all reasonable expenses incurred in carrying out his/her duties.
- You must sign at the bottom of these terms and conditions in the space titled ‘Grantor’.
- This form must be signed and witnessed by two witnesses along with their names.
- Finally this Form must be signed and sealed by the Notary Public from the county for this Alabama Durable Health Care Power of Attorney Form.
The final section contains blanks for the agent to fill in their details as required along with the declaration to serve as a health care agent for the grantor. You can download this Alabama Durable Health Care Power of Attorney Form by clicking on the link below.