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Other Names: Arizona Healthcare POA Arizona Healthcare Power of Attorney Arizona Medical POA Arizona Healthcare Proxy
Arizona Medical Power of Attorney document preview

What is an Arizona Medical Power of Attorney?

An Arizona Medical Power of Attorney is a legal document that gives a trusted person or organization the authority to make health-related decisions on your behalf, such as accepting or refusing medical treatment, if you cannot do so. 
The person giving control is called the "principal," and the people or entities gaining authority are known as the "agents." Suited for Arizona residents, our Power of Attorney for health care can be used in Maricopa County, Pima County, Pinal County, and in every other region in the state. All Arizona Healthcare PoA forms from Rocket Lawyer can be personalized for your unique scenario. With this essential legal document on hand, your representative will be able to offer verification to healthcare facilities and other parties that they can make choices for you.

When to use an Arizona Medical Power of Attorney:

  • You want to give someone the legal right to make healthcare decisions if you can't.
  • You're facing a dangerous surgery or are terminally ill.
  • You want a complete estate plan that covers your healthcare.

Sample Arizona Medical Power of Attorney

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I, , of , , as Principal, designate:


Agent Name:




Phone: Home: Work:

Relation, if any:


as my agent for all matters relating to my health care, including, without limitation, full power to give or refuse consent to all medical, surgical, hospital and related health care, including the provision of life-sustaining treatment This power of attorney is effective on my inability to make or communicate health care decisions. All of my agent's actions under this power during any period when I am unable to make or communicate health care decisions or when there is uncertainty whether I am dead or alive have the same effect on my heirs, devisees and person representatives as if I were alive, competent and acting for myself.




Agent Name:




Phone: Home: Work:


I have not completed or attached a living will.


I completed a prehospital medical directive pursuant to section 36-3251, Arizona Revised Statutes.


If any provision in this document is held to be invalid, such invalidity shall not affect the other provisions which can be given effect without the invalid provision, and to this end the directions in this document are severable.

I consent to an autopsy.I do not consent to an autopsy.My agent may give consent to or refuse an autopsy.

any needed organ or parts the following part or organs listed:

_____ I do not want to make an organ or tissue donation and I do not want my agent or family to do so.




My agent has authority to carry out all matters relating to my funeral and burial disposition wishes in accordance with this power of attorney, which is effective upon my death.



This health care directive is made under section 36-3221, Arizona Revised Statutes, and continues in effect for all who may rely on it except those to whom I have given notice of its revocation.




Signed on _____ day of _______________, _____.




Signature: ________________________________________







COUNTY OF ______________________________)

two witnesses who then sign the document in your presence and in each other's presence.a notary who then notarizes the document.

_____ Arizona requires that special provisions within the document be separately initialed or signed.


_____ should sign the Physician Affidavit.


Arizona Medical Power of Attorney FAQs

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  • How do I get Medical Power of Attorney in Arizona?

    It's fast and simple to grant or receive the support you need with a free Arizona Medical Power of Attorney template from Rocket Lawyer:

    1. Make your PoA - Answer a few basic questions and we will do the rest
    2. Send and share - Go over it with your agent or ask a lawyer
    3. Sign and make it legal - Optional or not, witnesses and notarization are a best practice

    This route is, in most cases, much less expensive and less time-consuming than meeting and hiring a traditional attorney. If necessary, you may prepare a Medical PoA on behalf of your spouse, an elderly parent, or another family member, and then have them sign it once you've drafted it. Please note that for this document to be considered legally valid, the principal must be an adult who is mentally competent when they sign. If the principal has already been declared incompetent, a conservatorship could be necessary. In this scenario, it would be a good idea for you to talk to an attorney .

  • Who should have a Power of Attorney for healthcare in Arizona?

    Every person over 18 ought to have a Medical Power of Attorney. While it can be unpleasant to think about, there will likely come a time when you are not able to make your own healthcare decisions. Typical circumstances where power of attorney might be helpful include:

    • You are getting older or have declining health
    • You are planning to live in a residential care facility
    • You will be in the hospital for a surgical procedure
    • You have been given a terminal diagnosis

    Whether this Arizona Medical Power of Attorney has been generated as part of a long-term plan or created in response to an emergency, witnesses and/or notarization will often help to protect your document if someone doubts its validity.

  • Are an Arizona Healthcare Proxy and an Arizona Medical Power of Attorney the same thing?

    Sometimes, when discussing the topics of elder care or estate planning with medical professionals, you or a loved one might hear the terms "healthcare power of attorney", "medical power of attorney" and "healthcare proxy" being used interchangeably. In reality, they are the same. That being said, please keep in mind that it's certainly possible to give power of attorney over affairs that aren't related to health care. In that case, "proxy" is not normally used.

  • Do I need to hire a lawyer to review my Arizona Medical PoA?

    Arizona Medical PoA forms are usually straightforward; however, you or your agent(s) might still have legal questions. Finding a legal professional to comment on your Arizona Medical Power of Attorney may be relatively time-intensive. An easier option is through Rocket Lawyer attorney services. If you sign up for a Premium membership, you can get your documents reviewed or send specific questions. As always, Rocket Lawyer is by your side.

  • On average, how much would I typically need to pay to get a Power of Attorney form for health care in Arizona?

    The fees associated with finding and hiring a conventional legal provider to write a Medical Power of Attorney might total anywhere between $200 and $500. Different from many other websites you might stumble upon, Rocket Lawyer offers much more than a Power of Attorney template. If you ever require help from a lawyer, your membership provides up to a 40% discount when you hire an Rocket Lawyer network attorney.

  • What are my next steps after drafting an Arizona Medical Power of Attorney?

    As a Rocket Lawyer member, you can edit it, save it as a Word or PDF document, or print it out. In order to complete your Power of Attorney, it should be signed. Take care to give a copy of the signed document to your agent(s) and care providers.

  • Does a Medical Power of Attorney need to be notarized, witnessed, and/or recorded in Arizona?

    The specifications and restrictions for PoA forms will vary by state; however, in Arizona, your Power of Attorney must be acknowledged by a notary public or signed by one witness. Witnesses to this PoA must not be anyone involved in your care, nor any relative, spouse, adoptee, heir, or any other beneficiary. Finally, as a general standard, witnesses should be over 18 years old, and no witness should simultaneously be your PoA agent.

    See Arizona Medical/Healthcare Power of Attorney law: § 36-3221

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