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Sample Mental Health Declaration and Power of Attorney Form Template
Mental Health Declaration and Power of Attorney Basics

A Mental Health Declaration and Power of Attorney helps you document your health care preferences and allows you to grant someone the authority to make mental health care decisions on your behalf should you ever be unable to make them yourself. Maybe you're playing it safe and want to be prepared if something happens, or maybe you're helping someone else with difficult decisions. A Mental Health Declaration and Power of Attorney gets your wishes in writing.

Use the Mental Health Declaration and Power of Attorney document if:

  • You want to make sure your future mental health wishes are granted.
  • You want to designate someone to make decisions for your mental health care if you are unable to do so yourself.
  • You anticipate treatment in a mental health facility.
  • Your have been diagnosed with a condition that may lead the inability to make mental health care decisions for yourself.

While most people don't think about future mental health issues, a Mental Health Declaration and Power of Attorney can be a wise move for anyone. If you have strong opinions about mental health care treatment it's best to get those wishes formalized in writing. You may want treatment at a certain hospital, or you may want to avoid certain medications or procedures. Perhaps you want to aid medical research and opt in to an experimental treatment, or avoid that entirely. Having everything documented can help ensure that your wishes are followed.

If you want to give someone else permission to make decisions for you, like a spouse, partner, or close friend, you can do that with a power of attorney document. Granting someone you trust power of attorney can be a good way to supplement your health care declaration. After all, it's nearly impossible to account for every situation that may happen in a written document. Having someone able to make health care decisions on your behalf can help protect your interests if you're met with circumstances that aren't enumerated in your declaration. Getting a Mental Health Declaration and Power of Attorney signed can help you prepare.

Other names for this document: Mental Health Care Declaration and Power of Attorney Form


Sample Mental Health Declaration and Power of Attorney

More than just a template, our step-by-step interview process makes it easy to create a Mental Health Declaration and Power of Attorney.

Save, sign, print, and download your document when you are done.

This document is sometimes called a Mental Health Care Declaration.

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