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WARNING TO PERSON EXECUTING THIS DOCUMENT
This is an important legal document. Before executing this document, you should know these important facts.
This document gives the person you designate as your Agent (the attorney-in-fact) the power to make health care decisions for you. Your Agent must act consistently with your desires as stated in this document.
Except as you otherwise specify in this document, this document gives your Agent the power to consent to your doctor not giving treatment or stopping treatment necessary to keep you alive.
Notwithstanding this document, you have the right to make medical and other health care decisions for yourself so long as you can give informed consent with respect to the particular decision. In addition, no treatment may be given to you over your objection, and health care necessary to keep you alive may not be stopped or withheld if you object at the time.
This document gives your Agent authority to consent, to refuse to consent, or to withdraw consent to any care, treatment, service, or procedure to maintain, diagnose, or treat a physical or mental condition. This power is subject to any limitations that you include in this document. You may state in this document any types of treatment that you do not desire. In addition, a court can take away the power of your Agent to make health care decisions for you if your Agent: (1) authorizes anything that is illegal; or (2) acts contrary to your desires as stated in this document.
You have the right to revoke the authority of your Agent by notifying your Agent or your treating physician, hospital or other health care provider orally or in writing of the revocation.
Your Agent has the right to examine your medical records and to consent to their disclosure unless you limit this right in this document.
Unless you otherwise specify in this document, this document gives your Agent the power after you die to: (1) authorize an autopsy; (2) donate your body or parts thereof for transplant or therapeutic or educational or scientific purposes; and (3) direct the disposition of your remains.
If there is anything in this document that you do not understand, you should ask an attorney to explain it to you.
DURABLE POWER OF ATTORNEY FOR HEALTH CARE
. DESIGNATION OF HEALTH CARE AGENT. I, , of , , appoint:
| Agent Name: |
| Address: |
| , |
| 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.
(None of the following may be designated as your Agent: (1) your treating health care provider, (2) a nonrelative employee of your treating health care provider, (3) an operator of a health care institution, or (4) a nonrelative employee of an operator of a health care institution.)
. 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 Durable Power of Attorney for Health Care, my attorney-in-fact may make health care decisions for me, before or after my death, to the same extent as I could make health care decisions if I had the capacity to do so, including:
(1) Making a disposition under the Uniform Anatomical Gift Act, compiled in title 68, chapter 30;
(2) Authorizing an autopsy pursuant to the Post Mortem Examination Act, compiled in title 38, chapter 7; and
(3) Directing the disposition of remains pursuant to title 68, chapter 4.
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. 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.
SECOND ALTERNATE AGENT
| Agent Name: |
| Address: |
| , |
| Phone: | Home: Work: |
. 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.
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.
(YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY)
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: | ________________________________________ |
| Name: |
| Address: |
| County |
| Name: |
| Address: |
| , |
| Name: | ________________________________ |
| Address: | ________________________________ |
| ________________________________ |
| ________________________________ |
| Name: |
| Address: |
| , |
| Name: | ________________________________ |
| Address: | ________________________________ |
| ________________________________ |
| ________________________________ |
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It is very simple to give or get the authority you might need using a free Tennessee Medical Power of Attorney template from Rocket Lawyer:
This method is often going to be much less expensive and less time-consuming than meeting and hiring the average law firm. If needed, you may start a Medical PoA on behalf of your spouse, an elderly parent, or another relative, and then have that person sign it after you've drafted it. Keep in mind that for a Power of Attorney to be considered 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 conservatorship might be required. When facing this scenario, it would be important to speak to a lawyer .
Every adult should have a Medical Power of Attorney. While it is difficult to think about, there could come a time when you can no longer make important decisions on your own. Here are a few common circumstances in which you may consider power of attorney to be useful:
Regardless of whether your Tennessee Medical Power of Attorney has been generated as part of a forward-looking plan or created as a result of an urgent issue, witnesses and/or notarization are highly recommended as a best practice for protecting your agent if their power and authority are doubted by a third party.
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 interchangeably. In reality, they're one and the same. That said, please keep in mind that it is possible to get power of attorney over affairs that aren't health-related, in which case, "proxy" is not usually used.
Tennessee Medical PoA forms are typically simple to make; however, you may still need advice. Finding a lawyer to comment on your Tennessee Medical Power of Attorney might be time-intensive and relatively expensive. A more cost-effective route is through attorney services at Rocket Lawyer. If you become a Premium member, you can get your documents reviewed by an Rocket Lawyer network attorney with relevant experience. You can rest assured that Rocket Lawyer is by your side.
The cost of finding and hiring your average lawyer to make a Medical Power of Attorney can total anywhere from $200 to $500, depending on your location. Unlike most other Power of Attorney template websites that you may discover, Rocket Lawyer offers Premium membership holders up to 40% in savings when hiring a lawyer, so an attorney from our Rocket Lawyer attorney network can act on your behalf if you ever require help.
With a Premium membership, you can make edits, download it as a Word document or PDF file, and print it out. To make your Power of Attorney truly legal, you will need to sign it. Your agent(s), care providers, and other impacted parties should get copies of your fully executed document.
The rules for PoA forms are different by state; however, in Tennessee, your Power of Attorney will need to be signed by a notary public or two witnesses. At least one witness should not be a relative, spouse, adopted child, heir, or any other beneficiary. As a general rule, your witness(es) should not be under the age of 18, and no witness should simultaneously be your PoA agent.
See Tennessee Medical/Healthcare Power of Attorney law: Title 34, Ch. 6, Part 2
