The West Virginia Medical Power of Attorney acquires the necessary legal permissions to effectively direct health care decision-making to an alternate individual. The contract is designed to initiate a written understanding of the selection of who will take over for another in the event that the principal is no longer able to make the important choices on their own. The document provides allocated sections to describe the person who will be granted the controls and a successor should they become incapacitated. Limitations and restrictions on the assumed powers can be fine-tuned to meet the declarant’s needs in the corresponding clauses. The paperwork must be signed and dated in the presence of an appointed notary and two (2) permissible witnesses to be lawfully binding in the state of West Virginia.
Laws
Statute – West Virginia Health Care Decisions Act (W.V.C. § 16-30)
Definition – “Health care decision” means a decision to give, withhold or withdraw informed consent to any type of health care, including, but not limited to, medical and surgical treatments, including life-prolonging interventions, nursing care, hospitalization, treatment in a nursing home or other extended care facility, home health care and the gift or donation of a body organ or tissue (§ 16-30-3(i)).
Signing Requirements – Acknowledgment by a notary official and two (2) accepted witnesses as designated by the West Virginia Code § 16-30-4.
Revocation – § 16-30-18
Other Versions
West Virginia Medical Power of Attorney Form – Version 1
Download: Adobe PDF
Additional Resources
- West Virginia Center for End-of-Life Care – Frequently Asked Questions About the Medical Power of Attorney
- West Virginia Center for End-of-Life Care – POST Patient Brochure
- West Virginia Center for End-of-Life Care – What is a Medical Power of Attorney?
- West Virginia University Medicine – Living Will and Medical Power of Attorney
Related Forms (7)
- Advance Directive (Medical POA & Living Will)
- Advance Directive for Mental Health
- Advance Directive Wallet Card
- Checklist for Surrogate Selection
- DNR (Do-Not-Resuscitate) Order and Card
- Durable (Financial) Power of Attorney Form
- Release of Information from the e-Directive Registry
Advance Directive (Medical POA & Living Will)
Download: Adobe PDF
Advance Directive for Mental Health
Download: Adobe PDF
Information Factsheet: Adobe PDF
Download: Adobe PDF
Checklist for Surrogate Selection
Download: Adobe PDF
Do Not Resuscitate (DNR) Order and Card
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF
Patient Authorization for Release of Information from the e-Directive Registry
Download: Adobe PDF
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