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OTHER NAMES Minnesota Healthcare POA Minnesota Healthcare Power of Attorney Minnesota Medical POA Minnesota Healthcare Proxy

What is a Minnesota Medical Power of Attorney?

A Minnesota Medical Power of Attorney is a legal document that grants a selected person permission to make healthcare decisions on your behalf, such as accepting or refusing a certain medical treatment or procedure, when you cannot do so. 
 
The person granting control is called the "principal," and the individual or entity receiving authority is called the "agent." Designed for residents of Minnesota, this Power of Attorney for health care is made for use in Hennepin County, Ramsey County, Dakota County, and in every other region in the state. All Minnesota Medical PoA forms from Rocket Lawyer can be tailored to address your specific situation. As a result of this official document, your agent will be able to provide confirmation to medical institutions and other parties that they can make choices for you.

When to use a Minnesota Medical Power of Attorney:

  • You want a certain person to make medical decisions for you if you can't.
  • You have concerns about declining health, or just want to be ready for anything.

Sample Minnesota Medical Power of Attorney

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HEALTHCARE POWER OF ATTORNEY

 

Notice:

 

This is an important legal document. Before signing this document, you should know these important facts:

(a) This document gives your health care providers or your designated proxy the power and guidance to make health care decisions according to your wishes when you are in a terminal condition and cannot do so. This document may include what kind of treatment you want or do not want and under what circumstances you want these decisions to be made. You may state where you want or do not want to receive any treatment.

(b) If you name a proxy in this document and that person agrees to serve as your proxy, that person has a duty to act consistently with your wishes. If the proxy does not know your wishes, the proxy has the duty to act in your best interests. If you do not name a proxy, your health care providers have a duty to act consistently with your instructions or tell you that they are unwilling to do so.

(c) This document will remain valid and in effect until and unless you amend or revoke it. Review this document periodically to make sure it continues to reflect your preferences.

(d) Your named proxy has the same right as you have to examine your medical records and to consent to their disclosure for purposes related to your health care or insurance unless you limit this right in this document.

(e) If there is anything in this document that you do not understand, you should ask for professional help to have it explained to you.

 

TO MY FAMILY, DOCTORS, AND ALL THOSE CONCERNED WITH MY CARE:

 

. APPOINTMENT OF HEALTH CARE AGENT. I, , of , , trust and appoint:

 

Agent Name:

 

Address:

  ,

Phone: Home: Work:

Relation, if any:

 

as my health care agent to make any health care decisions for me.

 

NOTICE: You should not appoint any of the following persons as your agent unless the individual appointed is related to you by blood, marriage, registered domestic partnership, or adoption:

(1) your health care provider or

(2) an employee of your health care provider.

 

SECOND ALTERNATE AGENT

 

Agent Name:

 

Address:

  ,

Phone: Home: Work:

Relation, if any:

 

. GENERAL STATEMENT OF AUTHORITY GRANTED. Subject to any limitations in this document, my health care agent is automatically given the powers listed below in (A) through (D). My health care agent must follow my health care instructions in this document or any other instructions I have given to my agent. If I have not given health care instructions, then my agent must act in my best interest.

 

My health care agent has the power to:

 

(A) Make any health care decision for me. This includes the power to give, refuse, or withdraw consent to any care, treatment, service, or procedures. This includes deciding whether to stop or not start health care (including artificially administered nutrition or hydration) that is keeping me or might keep me alive, and deciding about intrusive mental health treatment.

 

(B) Choose my health care providers.

 

(C) Choose where I live and receive care and support when those choices relate to my health care needs.

 

(D) Review my medical records and have the same rights that I would have to give my medical records to other people.

authorize my Agent, to the extent permitted by law, do not authorize my Agent

 

. NOMINATION OF GUARDIAN. I understand that under Minnesota law, the appointment of the health care agent in a health care directive is considered a nomination of that person to act as guardian or conservator if one needs to be appointed.

 

. 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.

 

(YOU MUST DATE AND SIGN THIS DOCUMENT)

 

I am thinking clearly, I agree with everything that is written in this document, and I have made this document willingly.

 

Signed on _____ day of ____________________, _____.

 

 

 

Signature: ________________________________________

 

Address:

  County

 

 

If I cannot sign my name, I can ask someone to sign this document for me.

 

 

 

____________________________________ Signature of the person who I asked to sign this document for me.

 

____________________________________ Printed name of the person who I asked to sign this document for me.

Name:

Address:

  ,

Name: ________________________________

Address: ________________________________

  ________________________________

  ________________________________

Name:

Address:

  ,

Name: ________________________________

Address: ________________________________

  ________________________________

  ________________________________

A notary public

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

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Minnesota Medical Power of Attorney FAQs

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  • Where can I get Power of Attorney papers?

    It's quick and easy to grant or receive the authority you might need with a free Minnesota Medical Power of Attorney template from Rocket Lawyer:

    1. Make your PoA - Provide a few general details and we will do the rest
    2. Send and share - Look over it with your agent or ask a lawyer
    3. Sign it - Mandatory or not, witnesses and notarization are a best practice

    This solution will often be much less expensive and less time-consuming than finding and hiring a traditional law firm. If necessary, you can prepare this Medical PoA on behalf of a relative, and then help that person sign when ready. Please remember that for this document to be considered legally valid, the principal must be an adult who is mentally competent at the time of signing. In the event that the principal has already been declared incompetent, a court-appointed conservatorship might be necessary. In this scenario, it's a good idea to work with an attorney .

    .
  • Why should I have a Power of Attorney for healthcare in Minnesota?

    Every person over 18 ought to have a Medical Power of Attorney. Although it's difficult to acknowledge, there will likely come a time when you can no longer make your own medical decisions. Here are some common situations where you may find PoA forms to be helpful:

    • You are getting older or have declining health
    • You are planning to move into a residential care facility
    • You plan to be undergoing an in-patient procedure that requires anesthesia
    • You are currently managing a terminal condition

    Whether your Minnesota Medical Power of Attorney is being generated as part of a long-term plan or made in response to an emergency, notarization and witnesses can help to protect your document if its legitimacy is disputed by a third party.

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

    At times, when discussing the topics of estate planning and/or elder care with medical professionals, you may hear "healthcare power of attorney", "medical power of attorney" and "healthcare proxy" used interchangeably. At the end of the day, they're the same. That said, you should keep in mind that it's certainly possible to establish agency over affairs that aren't related to medical care, in which case, "proxy" is not usually used.

  • Should I hire an attorney for my Minnesota Medical PoA?

    Minnesota Medical PoA forms are typically simple, but you or your agent may still have legal questions. Depending on whom you reach out to, some lawyers will not even accept requests to review documents that they did not draft. A more favorable approach to consider is to go through Rocket Lawyer attorney services. If you become a Premium member, you will be able to request guidance from an attorney with relevant experience or get answers to other questions related to your Medical Power of Attorney. We're here for you.

  • On average, how much would it normally cost me to get a Power of Attorney form for health care in Minnesota?

    The cost of hiring a lawyer to draft a Medical Power of Attorney could total anywhere from $200 to $500, depending on your location. When you use Rocket Lawyer, you aren't just filling out a Power of Attorney template. If you ever need help from a lawyer, your membership provides up to 40% in savings when you hire an attorney from our Rocket Lawyer attorney network.

  • Am I required to do anything else after creating a Minnesota Medical Power of Attorney?

    When you're finished creating a document with the help of Rocket Lawyer, you will have the ability to retrieve it wherever and whenever you choose. You also may engage with your document in all of these ways: making edits, downloading it as a PDF document or Word file, and signing it. Attached alongside each Power of Attorney form, there will be a checklist of tips on what is next after the document is completed. Your agent(s), care providers, and other impacted parties should get a copy of the final document.

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

    The specific requirements and restrictions vary in each state; however, in Minnesota, your document will need the signatures of two witnesses or a notary public. Only one of the witnesses to your Healthcare PoA can be your healthcare provider. Finally, as a general standard, witnesses must be 18 years old or older, and none of them should also be your agent.

    See Minnesota Medical/Healthcare Power of Attorney law: § 145C.07

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