You can find a free Healthcare Power of Attorney form for use in your state in a variety of places, including online. It is recommended that you tailor whatever form you start with to your individual needs and wishes. However, if that is a hassle for you, it is better to sign a standard Healthcare Power of Attorney than not have one at all.

The document should be witnessed by disinterested witnesses. How many witnesses are required depends on the state in which you live or are treated. State specific forms generally provide room for the correct number of witnesses for the specific state.

Give copies of the form to your Healthcare Proxy, doctor and other concerned people.

If you live in more than one state, or are treated in another state, your Healthcare Power of Attorney may be honored in the other state. However, to avoid hassles, it is advisable to execute a separate document which is valid in that state - naming the same people as Proxy and Alternate Proxy.

For information, see:

• Where To Find A Healthcare Power of Attorney Form For Use In The State In Which You Live
• Tips For Drafting A Healthcare Power Of Attorney
• How Many Copies Of A Healthcare Power of Attorney Should I Make And What Should I Do With Them?
• What To Do If You Live In More Than One State

The web site, www.caringinfo.org , contains free forms and the requirements for their execution for each state and the District of Columbia. You'll find the forms under the general heading: "Advance Directives". The site has information from the National Hospice and Palliative Care Organization (NHPCO).

Sanctuary, Inc. maintains Living Wills and similar forms and literature. Although the Living Will and Healthcare Proxy documents are free, Sanctuary requests a $25 donation with your order. Sanctuary combines a Healthcare Power of Attorney and a Living Will into one document. Sanctuary is located at 204-04 Hillside Avenue, Hollis, NY 11423. Telephone: 718.479.1000. www.healthproxylivingwill.org .

Many stationery, book, and office supply stores also sell forms that conform to your state's laws - particularly forms geared to each state by Rediform ® of Coppell, TX 75019 (their Durable Power of Attorney Kit is Legal Form 10175). If you are unable to locate a store that carries Rediform ® products, you call the Rediform hotline at 800.234.7586. As of this writing, you cannot order forms through their website, but it may be worth checking when you read this. See www.rediform.com

Another excellent source of your state's laws concerning Advance Directives are local non-profit organizations that serve seniors or people with a life-changing condition such as HIV/AIDS, cancer, or Alzheimer's.

When drafting your Healthcare Power of Attorney document:

• In order to avoid a conflict between your Health Care Proxy and the terms of your Living Will: Include a provision which basically states that if there is a conflict between the provisions of your Living Will and what the Proxy wants, which governs. For example: "In the event of a conflict between the terms of my Living Will and a decision of my Health Care Proxy, the decision of my Health Care Proxy shall control in all instances."
• You may give the person you select as your health care proxy as little or as much authority as you want. You may allow your agent to make all health care decisions or only certain ones. You may also give your agent instructions that he or she has to follow.
  
  • When drafting your document, check over the powers which are given to your Proxy. Eliminate any powers you do not want the Proxy to have. This is generally done by crossing through the wording and initialing the cross-through.
• If you do not want nutrition or hydration, or at least want to let your Proxy have the option to stop nutrition or hydration, include a specific provision that says in effect: "My agent knows my wishes about artificial nutrition and hydration." Without such a provision, it is possible that a local court will not follow a Proxy's request to not start nutrition and hydration - or to discontinue nutrition and hydration.
• Include addresses, mobile and land line telephone numbers, pager numbers, and e-mail addresses of your Healthcare Proxy and Alternate so your caregivers and/or medical team will be able to make contact quickly if necessary.
• Include a provision that specifically gives your Proxy the authority to be informed about your medical condition, including seeing your medical records. Doctors and health care facilities can be cautious about the requirements imposed by the federal law known as HIPAA and may deny access to that information without specific written authorization. Your proxy will likely ultimately gain authority to learn what's necessary, but that may involve a time delay and the expense of going to court.

Consider adding a space on the document for person named as Proxy to sign his or her name as agreeing to act as Proxy. It helps reinforce in that person's mind the importance of the agreement and their agreement to act as your Proxy. For example, at the bottom write:

The undersigned does hereby agree to act as Proxy under the terms of this document.

_______ (Person to sign here)______.

(Print the person's name)

Do not ask the proxy to be a witness or act as Notary to any Advance Directive such as a Living Will or Health Care Power Of Attorney. If the person named as proxy is also a witness, his or her testimony could be considered tainted if the document were ever contested.

NOTE: Even if it is not required in your state, it is advisable to execute this document in the presence of a Notary Public in case something happens to you while traveling. However, if this will slow down your executing the document, go ahead and execute the document without the Notary. Then, when you have time, you can execute another one in front of a Notary.

Since this is a matter which applies to all Advance Directives, to learn more, see: Who Should Receive Copies Of My Healthcare Power Of Attorney, Living Will and Do Not Resuscitate Order?

If you have residences in more than one state, it advisable to prepare (or ask an attorney to prepare) a document that fits the laws of each state in which you live. If this is not possible, or too cumbersome, create separate documents for each state. Be sure they say the same thing and appoint the same people as Proxy and Alternate Proxy so there is no confusion if it ever comes time to use the documents.