Printable Health Care Proxy Form Massachusetts The Health Care Proxy is a simple document legally valid in Massachusetts which allows you to name someone an agent to make health care decisions on your behalf if you are unable to make or communicate those decisions
Print the name address and phone number of the person you choose as your Health Care Agent Optional If you think your Agent might not be available at any future time you may name a second person as an Alternate Agent Your Alternate Agent will be called if your Agent is unwilling or unable to serve A Massachusetts health care proxy or medical power of attorney allows a principal to appoint a proxy to make healthcare decisions on their behalf The proxy will be instructed to follow in the wishes and desires of the principal For end of life treatment options the proxy should refer to the patient s Living Will Definition
Printable Health Care Proxy Form Massachusetts
Printable Health Care Proxy Form Massachusetts
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Fillable Online The Massachusetts Health Care Proxy Form Fax Email Print PdfFiller
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Print a Health Care Proxy form See a Health Care Proxy form in Spanish Complete and sign the form Ask two other people to sign the form as witnesses Put the form where it is easy to find Give a copy of your health care proxy form to your health care agent Remember to talk about your medical care preferences with your health care agent 1 I Principal PRINT your name residing at Street appoint as my Health Care Agent City or Town Name of person you choose as Agent State of Street City town State Phone OPTIONAL If my Agent is unwilling or unable to serve then I appoint as my Alternate Agent Name of person you choose as Alternate Agent of
7 1 14 Provides detailed information on when you can file a petition under GL c 201D necessary forms and how to file them in Probate and Family Court Petition for Special Proceeding in re a Health Care Proxy MPC 405 At the top of the form print your full name and address Print the name address and phone number of the person you choose as your Health Care Agent Optional If you think your Agent might not be available at any future time you may name a second person as an Alternate Agent
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The Massachusetts Health Care Proxy law Massachusetts General Laws Chapter 201D authorizes a competent adult who is age eighteen or older to appoint a Health Care Agent Your agent will have full authority to make any healthcare decisions when you are unable to make or communicate those decisions Get information about the Massachusetts Health Care Proxy a simple legal document that enables a patient to appoint someone they trust to make health care decisions if the patient is unable to do so
The Health Care Proxy Law was passed in 1990 Massachusetts General Laws Chapter 201D The form published by nonprofit Massachusetts Health Decisions meets all legal requirements and was developed by MHD with help from a Task Force of the 15 statewide organizations listed on the Proxy It is used by hospitals health plans nursing homes Massachusetts law about health care proxies and living wills Laws regulations and web sources on health care proxies and living wills If you are unable to find the information you are looking for or if you have a specific question please contact our law librarians for assistance Table of Contents Massachusetts laws Federal laws
Health Care Proxy Form Massachusetts Free Download
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Sample Healthcare Proxy Form Massachusetts Edit Fill Sign Online Handypdf
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https://www.massmed.org/healthcareproxy/
The Health Care Proxy is a simple document legally valid in Massachusetts which allows you to name someone an agent to make health care decisions on your behalf if you are unable to make or communicate those decisions
https://www.massgeneral.org/assets/mgh/pdf/obgyn/massachusetts%20health%20care%20proxy_english.pdf
Print the name address and phone number of the person you choose as your Health Care Agent Optional If you think your Agent might not be available at any future time you may name a second person as an Alternate Agent Your Alternate Agent will be called if your Agent is unwilling or unable to serve
Free Massachusetts Health Care Proxy Form PDF 202KB 5 Page s
Health Care Proxy Form Massachusetts Free Download
Sample Healthcare Proxy Form Massachusetts Free Download
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Health Care Proxy Forms Printable Printable Forms Free Online
Health Care Proxy Forms Printable Printable Forms Free Online
Health Care Proxy Form Massachusetts Free Download
Free Massachusetts Health Care Proxy Form PDF 24KB 4 Page s
Sample Healthcare Proxy Form Massachusetts Free Download
Printable Health Care Proxy Form Massachusetts - Call 781 784 1966 or email proxy masshealthdecisions A great deal of information about the Proxy for professionals and the public in English and 15 other languages is available at masshealthdecisions If you still wish to print a copy of the form click here Continue to Download Proxy Form pdf 4 pages Print
