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

What is a Delaware Medical Power of Attorney?

A Delaware Medical Power of Attorney is a legal document that gives a trusted person permission to make health-related decisions for you, such as refusing or accepting certain medical treatments, when you cannot do so. 
 
The individual giving permission is called the "principal," while the individual or entity obtaining powers is called the "agent." Designed for Delaware residents, our Power of Attorney for health care can be used in New Castle County, Sussex County, Kent County, and in every other county in the state. All Delaware Healthcare PoA forms from Rocket Lawyer can be modified for your particular scenario. Making this essential document will provide confirmation to healthcare facilities and other parties that your selected representative can act in your interest when you are not able.

When to use a Delaware Medical Power of Attorney:

  • You've been diagnosed with a serious or terminal illness and are preparing for the future.
  • You're healthy, but still want to legally appoint someone to make future medical decisions for you.

Sample Delaware Medical Power of Attorney

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HEALTHCARE POWER OF ATTORNEY

 

EXPLANATION

 

This form is a power of attorney for health care, allowing you to name another individual as agent to make health-care decisions for you if you become incapable of making your own decisions. You may also name an alternate agent to act for you if your first choice is not willing, able, or reasonably available to make decisions for you. Unless related to you, an agent may not have a controlling interest in or be an operator, or employee of a residential long-term health-care institution at which you are receiving care.

 

If you do not have a qualifying condition (terminal illness/injury or permanent unconsciousness), your agent may make all health-care decisions for you except for decisions providing, withholding, or withdrawing a life sustaining procedure. Unless you limit the agent's authority, your agent will have the right to:

 

(a) consent or refuse consent to any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a physical or mental condition unless it's a life-sustaining procedure or otherwise required by law.

(b) select or discharge health-care providers and health-care institutions;

 

If you have a qualifying condition, your agent may make all health-care decisions for you including but not limited to:

 

(c) The decisions listed in (a) and (b).

(d) Consent or refuse consent to life sustaining procedures, such as, but not limited to, cardiopulmonary resuscitation and orders not to resuscitate.

(e) Direct the providing, withholding, or withdrawal of artificial nutrition and hydration and all other forms of health care.

 

After completing this form, sign and date the form at the end. It is required that two other individuals sign as witnesses. Give a copy of the signed and completed form to your physician, to any other health-care providers you may have, to any health-care institution at which you are receiving care, and to any health-care agents you have named. You should talk to the person you have named as agent to make sure that he or she understands your wishes and is willing to take the responsibility.

 

You have the right to revoke this health-care power of attorney or replace this form at any time.

 

 

POWER OF ATTORNEY FOR HEALTH CARE

 

Your agent may make any health care decision that you could have made while you had the capacity to make health care decisions. You may appoint an alternate agent to make health care decisions for you if your first agent is not willing, able and reasonably available to make decisions for you. Unless the persons you name as agent and alternate agent are related to you by blood, neither may own, operate or be employed by a residential long-term care institution where you are receiving care. You may cross out any wording you do not want.

 

() DESIGNATION OF AGENT: I designate the following individual as my agent to make health-care decisions for me:

,

Home Phone: Work Phone:

 

() AGENT'S AUTHORITY:

 

() WHEN AGENT'S AUTHORITY BECOMES EFFECTIVE: My agent's authority becomes effective when my primary physician determines I lack the capacity to make my own health-care decisions. As to decisions concerning the providing, withholding and withdrawal of life-sustaining procedures my agent's authority becomes effective when my primary physician determines I lack the capacity to make my own health-care decisions and my primary physician and another physician determine I am in a terminal condition or permanently unconscious.

 

() AGENT'S OBLIGATION: My agent shall make health-care decisions for me in accordance with this power of attorney for health care, any instructions I give in this form, and my other wishes to the extent known to my agent. To the extent my wishes are unknown, my agent shall make health-care decisions for me in accordance with what my agent determines to be in my best interest. In determining my best interest, my agent shall consider my personal values to the extent known to my agent.

 

() NOMINATION OF GUARDIAN: If a guardian of my person needs to be appointed for me by a court, I

 

() EFFECT OF COPY: A copy of this form has the same effect as the original.

 

() SIGNATURE: Sign and date the form here: I understand the purpose and effect of this document.

 

Date: ___________________________

 

 

 

____________________________________________

Signature

,

 

 

() SIGNATURES OF WITNESSES:

 

Statement of Witnesses

 

SIGNED AND DECLARED by the above-named declarant as and for his/her written declaration under 16 Del. C. Sections 2502, 2503, in our presence, who in his/her presence, at his/her request, and in the presence of each other, have hereunto subscribed our names as witnesses, and state:

 

A. That the declarant is mentally competent.

B. That neither of us:

1. Is related to the declarant by blood, marriage or adoption;

2. Is entitled to any portion of the estate of the declarant under any will of the declarant or codicil thereto then existing nor, at the time of the executing of the advance health care directive, is so entitled by operation of law then existing;

3. Has, at the time of the execution of the advance health-care directive, a present or potential claim against any portion of the estate of the declarant;

4. Has a direct financial responsibility for the declarant's medical care;

5. Has a controlling interest in or is an operator or an employee of a residential long-term health-care institution in which the declarant is a resident; or

6. Is under eighteen years of age.

C. That if the declarant is a resident of a sanitarium, rest home, nursing home, boarding home, or related institution, one of us is, at the time of the execution of the advance health-care directive, a patient advocate or ombudsman designated by the Division of Services for Aging and Adults with Physical Disabilities or the Public Guardian.

 

 

First Witness:

 

 

____________________________________________________

(Signature of Witness)(Date)

 

I am not prohibited by Section 2503 of Title 16 of the Delaware Code from being a witness.

 

 

Second Witness:

 

 

____________________________________________________

(Signature of Witness)(Date)

 

I am not prohibited by Section 2503 of Title 16 of the Delaware Code from being a witness.

 

 

Statement of Patient Advocate or Ombudsman

 

(If the declarant is a patient in a skilled nursing facility, one of the witnesses must be a patient advocate or ombudsman. The following statement is required only if the declarant is a patient in a skilled nursing facility, a health-care facility that provides the following basic services: skilled nursing care and supportive care to patients whose primary need is for availability of skilled nursing care on an extended basis. The patient advocate or ombudsman must sign the "Statement of Witnesses" above AND must also sign the following statement.)

 

I declare that I am a patient advocate or ombudsman as designated by the Division of Services for Aging and Adults with Physical Disabilities or the Public Guardian.

 

 

____________________________________________________

(Signature of patient advocate or ombudsman)(Date)

A person witnessing your signatureA second person witnessing your signature

Delaware Medical Power of Attorney FAQs

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

    It's simple and easy to give or get the authority you might need using a free Delaware Medical Power of Attorney template from Rocket Lawyer:

    1. Make the document - Answer a few basic questions and we will do the rest
    2. Send and share - Discuss the document with your agent or ask a legal question
    3. Sign it and make it legal - Mandatory or not, witnesses and notarization are a best practice

    This solution is, in most cases, notably less time-consuming than meeting and hiring your average lawyer. If needed, you may start a Medical PoA on behalf of a family member, and then have them sign after you've drafted it. Please remember that for a PoA form to be accepted as valid, the principal must be an adult who is mentally competent at the time of signing. If the principal is already incapacitated and unable to make their own decisions, a court-appointed conservatorship generally will be necessary. When managing such a scenario, it is important for you to connect with an attorney .

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

    Every adult should have a Medical Power of Attorney. Though it is unpleasant to think about, a day may come when you are no longer able to make healthcare decisions on your own. Here are some typical circumstances in which a PoA might be helpful:

    • You are getting older or dealing with ongoing health issues
    • You reside in or are planning to move into a care facility
    • You are facing the possibility of a medical procedure or a hospitalization
    • You are managing a terminal condition

    Regardless of whether your Delaware Medical Power of Attorney is being created in response to an urgent issue or as part of a long-term plan, witnesses and notarization are strongly recommended as a best practice for protecting your agent if their authority is questioned.

  • What is the difference between a Delaware Healthcare Proxy and a Delaware Medical Power of Attorney?

    At times, in researching the topics of elder care and estate planning, you or a loved one may hear the terms "healthcare power of attorney", "medical power of attorney" and "healthcare proxy" being used together. In reality, they're the same. That said, you should keep in mind that it's entirely possible to get agency over matters that are not related to health care. In that case, "proxy" usually is not the term of choice.

  • Do I need to hire an attorney for my Delaware Medical PoA?

    Delaware Medical PoA forms are generally simple; however, you or your agent might need advice. Getting another pair of eyes on your document may take a long time on your own. Another approach would be through the Rocket Lawyer On Call® attorney network. Rocket Lawyer members are able to request guidance from an Rocket Lawyer network attorney with relevant experience or get answers to additional legal questions. As always, you can be confident that Rocket Lawyer is here by your side.

  • What would it normally cost for a lawyer to help me get a Power of Attorney form for health care in Delaware?

    The fees associated with meeting and hiring your average lawyer to generate a Medical Power of Attorney might range between $200 and $500, depending on your location. Rocket Lawyer can offer much more protection than many other Power of Attorney template websites that you may find elsewhere. As a Rocket Lawyer Premium member, you can get up to a 40% discount when hiring an attorney.

  • Are there any additional steps that I should take once I draft a Delaware Medical Power of Attorney?

    As a Rocket Lawyer member, you will be able to edit it, save it in PDF format or as a Word file, and/or print it. In order to finalize your Power of Attorney, it must be signed. You should be sure to send a final copy of your fully signed document to your agent(s) and care providers.

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

    The requirements and restrictions governing PoA forms vary in each state; however, in Delaware, your Power of Attorney will require the signatures of two witnesses. The witnesses to your form should not be anyone who is responsible for your healthcare costs or who is affiliated with the healthcare facility that is providing your care. They should also not be your family members (including your spouse), heirs, or any other beneficiaries. As a general rule, your witness(es) will need to be 18 years old or older, and none of them should also be your agent.

    See Delaware Medical/Healthcare Power of Attorney law: Title 16, Ch. 25

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