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

What is a New Jersey Medical Power of Attorney?

A New Jersey Medical Power of Attorney is a legal document that grants someone else the authority to make healthcare decisions on your behalf, such as accepting or refusing medical treatment, when you cannot do so. 
The individual granting permission is called the "principal," while the individuals or entities gaining authority are known as the "agents." Designed for New Jersey residents, this Power of Attorney for health care can be used in Bergen County, Middlesex County, Essex County, and in all other regions in the state. All New Jersey Medical PoA forms from Rocket Lawyer can be edited to address your unique scenario. This legal document provides confirmation to healthcare institutions and other parties that your selected agent is legally allowed to make choices for you when you are not able.

When to use a New Jersey Medical Power of Attorney:

  • You have health concerns, and want to make sure someone you trust can take over if you become unable to make decisions yourself.
  • You're in great health, but you want to cover all your bases just in case.

Sample New Jersey Medical Power of Attorney

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I understand that as a competent adult, I have the right to make decisions about my health care. There may come a time when I am unable, due to physical or mental incapacity, to make my own health care decisions. In these circumstances, those caring for me will need direction and they will turn to someone who knows my values and health care wishes. By writing this durable power of attorney for health care, I appoint a health care representative with the legal authority to make health care decisions on my behalf and to consult with my physician and others. I direct that this document become part of my permanent medical records.




Agent Name:




Phone: Home: Work:

Relation, if any:


as my Agent to make health care and personal decisions for me if I become unable to make such decisions for myself, except to the extent I state otherwise in this document.


NOTICE: An operator, administrator or employee of a health care institution in which you are a patient or resident shall NOT serve as your Health Care Agent unless the operator, administrator or employee is related to you by blood, marriage or adoption. This restriction does not apply to a physician, if the physician does not serve as your attending physician and your Health Care Agent at the same time.


. CREATION OF DURABLE POWER OF ATTORNEY FOR HEALTH CARE. By this document I intend to create a Durable Power of Attorney for Health Care. This power of attorney shall take effect upon my disability, incapacity, or incompetency, and shall continue during such disability, incapacity, or incompetency.


. GENERAL STATEMENT OF AUTHORITY GRANTED. Subject to any limitations in this document, I grant to my Agent full power and authority to make health care decisions for me to the same extent that I could make such decisions for myself if I had the capacity to do so. "Health Care Decision" means a decision to accept or to refuse any treatment, service or procedure used to diagnose, treat or care for my physical or mental condition, including life-sustaining treatment.



My Agent may also accept or refuse the services of a particular physician, nurse, other health care professional or health care institution, including a decision to accept or to refuse a transfer of care.


In exercising this authority, my Agent shall make health care decisions that are consistent with my desires as stated in this document or otherwise made known to my Agent. In making any decision, my Agent shall attempt to discuss the proposed decision with me to determine my desires if I am able to communicate in any way. If my desires regarding a particular health care decision are not known to my Agent, then my Agent shall make the decision for me based upon what my Agent believes to be in my best interests.

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




Agent Name:




Phone: Home: Work:


. DURATION. I understand that this power of attorney becomes operative when (1) it is transmitted to my attending physician or to the health care institution responsible for my health care, and (2) my attending physician determines in writing that I lack the capacity to make a particular health care decision. My attending physician's determination of a lack of decision-making capacity shall be confirmed in writing by one or more physicians.




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.


3. STATEMENT OF INTENTIONS. It is my intent that this document be legally binding and effective. If the law does not recognize this document as legally binding and effective, it is my intent that this document be taken as a formal statement of my desire concerning the method by which any health care decisions should be made on my behalf during any period in which I am unable to make such decisions.




I have read and understand the contents of this document and the effect of this grant of powers to my Agent. I am emotionally and mentally competent to make this declaration.


Signed on _____ day of _______________, _____.




Signature: ________________________________________










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

New Jersey Medical Power of Attorney FAQs

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  • How do I get a Power of Attorney in New Jersey?

    It's simple and easy to grant or receive the support you need using a free New Jersey Medical Power of Attorney template from Rocket Lawyer:

    1. Make the PoA - Answer a few basic questions and we will do the rest
    2. Send or share it - Look over the PoA with your agent(s) or get legal help
    3. Sign it - Mandatory or not, witnesses and notarization are recommended

    This route is often notably less expensive and less time-consuming than finding and working with a conventional attorney. If needed, you may fill out a Medical PoA on behalf of your spouse, an elderly parent, or another family member, and then help that person sign once you've drafted it. Please note that for this document to be valid, the principal must be an adult who is mentally competent at the time of signing. If the principal has already been declared incompetent, a conservatorship generally will be required. When facing this situation, it's important for you to talk to an attorney .

  • Why should I have a Power of Attorney for healthcare in New Jersey?

    Every person over 18 years old ought to have a Medical Power of Attorney. Even though it may be painful to acknowledge, a day could come when you are no longer able to make medical decisions on your own. Typical occasions in which power of attorney would be useful include:

    • You intend to move into a care facility
    • You've been given a terminal diagnosis
    • You are getting older or dealing with ongoing health issues
    • You plan to undergo an in-patient procedure requiring anesthesia

    Whether your New Jersey Medical Power of Attorney has been drafted as part of a forward-looking plan or created as a result of an unexpected issue, notarization and witnesses often help to protect your document if its authenticity is questioned.

  • What are the differences between a New Jersey Healthcare Proxy and a New Jersey Medical Power of Attorney?

    Sometimes, in researching the subjects of elder care and estate planning, you may hear the terms "healthcare power of attorney", "medical power of attorney" and "healthcare proxy" used interchangeably. At the end of the day, they are one and the same. That being said, please keep in mind that it is absolutely possible to give power of attorney over affairs that are not health-related, in which case, "proxy" typically is not the preferred term.

  • Should I hire an attorney to review my New Jersey Medical PoA?

    New Jersey Medical PoA forms are usually simple; however, you could still need advice. Depending on whom you contact, some attorneys won't even accept requests to review documents that they did not work on. A better approach worth consideration is to get help via attorney services at Rocket Lawyer. When you become a Premium member, you have the ability to request guidance from an attorney with relevant experience or get answers to other questions about your Medical Power of Attorney. As always, Rocket Lawyer is here for you.

  • How much would I typically have to pay for a lawyer to help me get a Power of Attorney form for health care in New Jersey?

    The fees associated with finding and working with the average lawyer to produce a Medical Power of Attorney can add up to between $200 and $500, depending on your location. Rocket Lawyer can offer much more protection than most other Power of Attorney template websites that you might discover. As a Rocket Lawyer member, you can get up to 40% in savings when hiring an attorney from our network.

  • Am I required to do anything else after writing a New Jersey Medical Power of Attorney?

    Each Power of Attorney comes with its own series of instructions for what is next with regard to finalizing the document. With a membership, you will be able to make edits, save it as a Word or PDF document, and/or sign it. Finally, you will need to give a final copy of your fully signed document to your agent(s), care providers, and other impacted parties.

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

    The specifications and restrictions governing PoA forms will be different by state; however, in New Jersey, your document will need to be signed by a notary public or two witnesses. As a general principle, witnesses will need to be 18 years old or older, and none of them should also be acting as your PoA agent.

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