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  • Health Care Proxy - Massachusetts Medical Care - Lahey

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HEALTH CARE PROXY PATIENT INFORMATION: Patient Full Name: Date of Birth: Patient Address: City: State: Zip: Home Phone: Work Phone: Email Address: I APPOINT AS MY HEALTH CARE AGENT: Full Name: Email.

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No, a lawyer or notary is not required and you do not need to file your completed Proxy with any state or government agency. The Proxy was designed to be completed by any competent adult and two witnesses.

You do not need to notarize your Massachusetts healthcare proxy. Should I add personal instructions to my Massachusetts healthcare proxy? One of the strongest reasons for naming a proxy is to have someone who can respond flexibly as your medical situation changes and deal with situations that you did not foresee.

The Health Care Proxy law (MGL 201D) says that the patient's “attending physician” is the only person who can make that determination, though she should enlist the help of a specialist if the patient's incapacity is due to a mental illness or developmental disability.

Witness Statement and Signature (Required) Any competent adult can be a witness except your Health Care Agent and Alternate Agent. Two adults must be present as witnesses when this document is signed.

Massachusetts Health Care Proxy Form Choose someone you trust the most to: ... Print a Health Care Proxy form. ... 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.

Can I name more than one person as my Agent? No. Name only one person as your Agent and one person as your Alternate. Naming two people as co-agents might present a legal problem and could set up the kind of conflict about your care that the Health Care Proxy law was designed to avoid.

The Health Care Proxy is a simple legal document that allows you to name someone you know and trust to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232