Pennsylvania Medical Power of Attorney Template

Pennsylvania rules built into this template

• Signing: This document must be signed and dated by the Principal and witnessed by two individuals who are 18 years of age or older (20 Pa. Cons. Stat. § 5452).
• Pennsylvania provides an optional health care power of attorney form (20 Pa. Cons. Stat. § 5471).

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 Pennsylvania?

This document must be signed and dated by the Principal and witnessed by two individuals who are 18 years of age or older (20 Pa. Cons. Stat. § 5452).

Can my healthcare agent see my medical records in Pennsylvania?

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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• North Carolina
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