California · Standard edition

California Medical Power of Attorney Template

Create a California medical power of attorney online to name a healthcare agent. The Standard document covers the agent's authority, when it begins, the decision standard, life-sustaining treatment instructions, a HIPAA authorization, revocation, and California witness and notary requirements.

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California rules built into this template

  • Signing: This document must be signed and dated by the Principal and either acknowledged before a notary public or signed by two qualified adult witnesses. The Agent, the Principal's health care provider or its employees, and operators or employees of a community care or residential care facility for the elderly may not be witnesses, and at least one witness may not be related to the Principal by blood, marriage, or adoption or be entitled to any part of the Principal's estate (Cal. Prob. Code §§ 4673, 4674). If the Principal is a patient in a skilled nursing facility, a patient advocate or ombudsman must also sign as a witness (Cal. Prob. Code § 4675).
  • California offers an optional statutory Advance Health Care Directive form (Cal. Prob. Code § 4701).

What the Medical Power of Attorney includes

  1. Appointment of Agent
  2. Authority of Agent
  3. When Authority Begins
  4. Standard for Decisions
  5. Life-Sustaining Treatment and Special Instructions
  6. HIPAA Authorization
  7. Limitations
  8. Duration and Revocation
  9. Reliance and Liability
  10. Execution
  11. State-Specific Information
  12. Governing Law

Frequently asked questions

Who can witness a medical power of attorney in California?
This document must be signed and dated by the Principal and either acknowledged before a notary public or signed by two qualified adult witnesses. The Agent, the Principal's health care provider or its employees, and operators or employees of a community care or residential care facility for the elderly may not be witnesses, and at least one witness may not be related to the Principal by blood, marriage, or adoption or be entitled to any part of the Principal's estate (Cal. Prob. Code §§ 4673, 4674). If the Principal is a patient in a skilled nursing facility, a patient advocate or ombudsman must also sign as a witness (Cal. Prob. Code § 4675).
Can my healthcare agent see my medical records in California?
Yes, if you include the HIPAA authorization. The Standard document can name your agent as your personal representative under HIPAA so providers can share your health information with them.
What is the difference between the Standard and Professional Medical Power of Attorney?
The Standard edition is a complete, state-aware Medical Power of Attorney for common situations. The Professional edition adds longer clause coverage, schedules, and optional modules for more complex matters. You can preview either edition free before you pay.

Medical Power of Attorney templates for other states

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Start your California Medical Power of Attorney