Appoint a healthcare agent in Connecticut: Connecticut Medical Power of Attorney
What is a Connecticut Medical Power of Attorney?
A Connecticut Medical Power of Attorney is a legal document that gives a person or organization permission to make health-related decisions for you, such as refusing or requesting specific medical treatments, when you cannot do so.
The individual granting control is called the "principal," and the person or organization obtaining authority is known as the "agent." Suited for Connecticut residents, this Power of Attorney for health care is made for use in Fairfield County, Hartford County, New Haven County, and in any other part of the state. All Connecticut Medical PoA forms from Rocket Lawyer can be completely personalized for your unique circumstances. As a result of having this essential document, your agent(s) can provide confirmation to medical providers and other parties that they can act in your interest.
When to use a Connecticut Medical Power of Attorney:
- You've selected someone to act on your behalf if you're ever unable to make healthcare decisions.
- You have a big surgery coming up and want to be ready for anything.
How do I get my Connecticut Medical Power of Attorney reviewed?
If you already have a Connecticut Medical Power of Attorney and want to have it reviewed, or if you have questions about creating or using one, there are a few ways to get help.
Use Rocket Copilot to ask questions or review your document; this helps you better understand what it says and identify anything that may need a closer look.
If you are looking for help from a Legal Pro, you can also ask a question and receive a response within one business day, or request a more in-depth document review.
What is a Connecticut Medical Power of Attorney?
A Connecticut Medical Power of Attorney is a legal document that gives a person or organization permission to make health-related decisions for you, such as refusing or requesting specific medical treatments, when you cannot do so.
The individual granting control is called the "principal," and the person or organization obtaining authority is known as the "agent." Suited for Connecticut residents, this Power of Attorney for health care is made for use in Fairfield County, Hartford County, New Haven County, and in any other part of the state. All Connecticut Medical PoA forms from Rocket Lawyer can be completely personalized for your unique circumstances. As a result of having this essential document, your agent(s) can provide confirmation to medical providers and other parties that they can act in your interest.
When to use a Connecticut Medical Power of Attorney:
- You've selected someone to act on your behalf if you're ever unable to make healthcare decisions.
- You have a big surgery coming up and want to be ready for anything.
How do I get my Connecticut Medical Power of Attorney reviewed?
If you already have a Connecticut Medical Power of Attorney and want to have it reviewed, or if you have questions about creating or using one, there are a few ways to get help.
Use Rocket Copilot to ask questions or review your document; this helps you better understand what it says and identify anything that may need a closer look.
If you are looking for help from a Legal Pro, you can also ask a question and receive a response within one business day, or request a more in-depth document review.
Sample Connecticut Medical Power of Attorney
The terms in your document will update based on the information you provide
This document has been customized over 6.3K times
Legally binding and enforceable
Consult a Legal Pro to ask questions or review your document
APPOINTMENT OF HEALTH CARE REPRESENTATIVE
. DESIGNATION OF HEALTH CARE AGENT. I appoint:
| Agent Name: |
| Address: |
| , |
| Phone: | Home: Work: |
| Relation, if any: |
to be my health care agent and my attorney-in-fact for health care decisions. If my attending physician determines that I am unable to understand and appreciate the nature and consequences of health care decisions, and I am unable to reach and communicate an informed decision regarding treatment, my health care agent and attorney-in-fact for health care decisions is authorized to:
(a) Convey to my physician my wishes concerning the withholding or removal of life support systems;
(b) Take whatever actions are necessary to ensure that my wishes are given effect;
(c) Consent, refuse or withdraw consent to any medical treatment as long as such action is consistent with my wishes as stated in this document or otherwise made known concerning the withholding or removal of life support systems
(d) Consent to any medical treatment designated solely for the purpose of maintaining physical comfort.
SECOND ALTERNATE AGENT
| Agent Name: |
| Address: |
| , |
| Phone: | Home: Work: |
any needed organs or parts only the following organs or parts: any purpose permitted by law.these limited purposes: I authorize my agent, to the extent permitted by law, to consent to an autopsy.I do not authorize my agent to consent to an autopsy.
No bond shall be required of my conservator in any jurisdiction.
. GENERAL PROVISIONS.
1. HOLD HARMLESS. All persons or entities who in good faith endeavor to carry out the terms and provisions of this document shall not be liable to me, my estate, my heirs or assigns for any damages or claims arising because of their action or inaction based on this document, and my estate shall defend and indemnify them.
2. SEVERABILITY. If any provision of 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.
These requests, appointments, and designations are made after careful reflection, while I am of sound mind, Any party receiving a duly executed copy or facsimile of this document may rely upon it unless such party has received actual notice of my revocation of it.
Signed on _____ day of _______________, _____.
| Signature: | ________________________________________ |
| Name: |
| Address: |
| County |
STATEMENT OF WITNESSES
This document was signed in our presence by , the author of this document, who appeared to be eighteen years of age or older, of sound mind, and able to understand the nature and consequences of health care decisions at the time this document was signed. The author appeared to be under no improper influence. We have signed this document in the author's presence and at the author's request and in the presence of each other.
| Witness Signature: | ________________________________________ |
Date: _________________________
| Witness Signature: | ________________________________________ |
Date: _________________________
(NOTE: THE PERSON(S) APPOINTED AS HEALTH CARE AGENT OR ALTERNATE AGENT SHALL NOT ACT AS WITNESSES. Also, if the author resides in a facility operated or licensed by the department of mental health and addiction services, at least one witness shall be an individual who is NOT affiliated with the facility and at least one witness shall be a physician or clinical psychologist with specialized training in treating mental illness. For persons who reside in a facility operated or licensed by the department of mental retardation, at least one witness shall be an individual who is NOT affiliated with the facility and at least one witness shall be a physician or clinical psychologist with specialized training in developmental disabilities.)
(OPTIONAL FORM)
WITNESSES' AFFIDAVITS
STATE OF CONNECTICUT
COUNTY OF _________________________
We, the subscribing witnesses, being duly sworn, say that we witnessed the execution of this document by the author of this document; that the author subscribed, published and declared the same to be the author's instructions, appointments and designation in our presence, that we thereafter subscribed the document as witnesses in the author's presence, at the author's request, and in the presence of each other, that at the time of the execution of said document the author appeared to us to be eighteen years of age or older, of sound mind and able to understand the nature and consequences of said document, and under no improper influence, and we make this affidavit at the author's request this ______ day of ____________________, _____.
________________________________________
________________________________________
Subscribed and sworn to before me this ______ day of ____________________, _____.
________________________________________
Commission of the Superior Court Notary Public
My commission expires: _________________________
Connecticut Medical Power of Attorney FAQs
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How can I get a Connecticut Medical Power of Attorney template for free?
It is very simple to grant or obtain the authority you may need with a free Connecticut Medical Power of Attorney template from Rocket Lawyer:
- Make the document - Answer a few simple questions and we will do the rest
- Send and share it - Look over it with your agent or get legal help
- Sign it and make it legal - Required or not, notarization and witnesses are encouraged
This solution will often be notably less time-consuming than meeting and hiring your average law firm. If necessary, you may start a Medical PoA on behalf of your spouse or another relative, and then have them sign it when ready. Please remember that for a Power of Attorney to be legally valid, the principal must be a mentally competent adult when they sign. In the event that the principal is already incapacitated and unable to make their own decisions, a court-appointed conservatorship might be necessary. When managing this scenario, it would be best to Consult an Legal Pro.
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Who should have a Power of Attorney for healthcare in Connecticut?
Anyone who is over 18 years old should have a Medical Power of Attorney. While it's tough to think about, a time could come when you cannot make your own medical decisions. Here are some common occasions where power of attorney would be helpful:
- You have plans to move into an adult care facility
- You are currently managing a terminal condition
- You are aging or have declining health
- You are planning to undergo a medical procedure requiring anesthesia
Regardless of whether this Connecticut Medical Power of Attorney is being prepared as part of a long-term plan or created as a result of an urgent issue, notarization and witnesses can help to protect your agent if someone questions their authority.
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Are a Connecticut Healthcare Proxy and a Connecticut Medical Power of Attorney different things?
At times, in researching the subjects of elder care and estate planning, you may hear "healthcare power of attorney", "medical power of attorney" and "healthcare proxy" used interchangeably. In reality, they are the same. That being said, you should keep in mind that it's possible to have power of attorney over matters that aren't health-related. In that case, "proxy" generally is not the preferred term.
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Should I work with an attorney for my Connecticut Medical PoA?
It’s a good idea to have important documents like your Connecticut Medical Power of Attorney reviewed before signing, so you fully understand your choices and help avoid unintended outcomes. The problem is that some attorneys may not review documents they didn’t prepare, while others may require a retainer or high hourly fees. This can make getting a legal review of your Connecticut Medical Power of Attorneydifficult and time-consuming.
Rocket Lawyer makes the process easier. With Rocket Lawyer, you can request a review from a Legal Pro or ask questions about your document. You can also use Rocket Copilot to review your document, identify potential issues, and check that everything is complete before signing.
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How much might I normally have to pay to get a Power of Attorney form for health care in Connecticut?
Attorney fees for drafting or reviewing a Connecticut Medical Power of Attorney can vary widely. Many lawyers charge hourly rates that may range from around $100 for less experienced attorneys to $350 or more per hour for highly experienced attorneys in major metropolitan areas. For more routine documents, some attorneys may offer flat-fee pricing.
The total cost will depend on several factors, including your location, the attorney’s experience, and the complexity of your agreement. More documents or situations involving negotiation will typically require more time and increase the overall cost.
With Rocket Lawyer, you can create a personalized Connecticut Medical Power of Attorney tailored to your specific needs—without the high cost typically associated with hiring a lawyer. If you have questions or want additional peace of mind, you can also get your document reviewed or ask a Legal Pro for guidance.
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Does a Medical Power of Attorney need to be notarized, witnessed, and/or recorded in Connecticut?
The guidelines for PoA forms will be different in each state; however, in Connecticut, your document will require two witnesses. Finally, as a basic rule, witnesses must be 18 years old or older, and no witness should simultaneously be designated as your PoA agent.
See Connecticut Medical/Healthcare Power of Attorney law: Sec. 19a-575
