The Washington Medical Power of Attorney furnishes paperwork to corroborate the granting of controls over health care decisions to an alternate party. The bestowed agency is transferred for the purpose of indicating a preferred party to make selections regarding the principal’s treatment options should they no longer be able to make the decisions on their own. The declarant can issue the form to prepare for situations where unconsciousness may occur or a persistent vegetative state. The person selected to receive the authority to allocate determinations of the principal’s health should be carefully designated because of the associated responsibility inherited with the agreement’s signing. Signatures must be obtained under the observation of a notary professional or by affirmation of two (2) witnessing individuals allowed by the Revised Code of Washington § 11-125-050 to certify the commitment properly.
Laws
Statute – Washington Natural Death Act (R.C.W. § 70-122-010 – § 70-122-925 ) and Uniform Power of Attorney Act (R.C.W. § 11-125-010 – § 11-125-903)
Definition – “Power of attorney” means a writing that uses the term “power of attorney” and grants authority to an agent to act in the place of the principal (§ 11-125-020(7)).
Signing Requirements – It is required to have a notary present to view the signing process or, in place of a notary, two (2) qualified witnesses (§ 11-125-050).
Other Versions (7)
- Everplans
- Honoring Choices
- Multicare
- Swedish Health Services
- University of Washington Medicine
- Washington State Hospital Association
- Washington State Medical Association
Download: Adobe PDF
Honoring Choices Washington Version
Download: Adobe PDF
Download: Adobe PDF
Swedish Health Services Washington Version
Download: Adobe PDF
University of Washington Medicine Version
Download: Adobe PDF
Washington State Hospital Association Version
Download: Adobe PDF
Washington State Medical Association Version
Download: Adobe PDF
Additional Resources
- Northwest Justice Project – Durable Power of Attorney Documents Information
- Washington Law Help – Durable Power of Attorney Documents
- Washington State Department of Social and Health Services – Legal Planning
Related Forms (5)
- Advance Directive (Medical POA & Living Will)
- Advance Directive for Mental Health
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- POLST Form
Advance Directive (Medical POA & Living Will)
Download: Adobe PDF
Advance Directive for Mental Health
Download: Adobe PDF, MS Word (.docx)
Instructions: Adobe PDF
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
POLST (Physician Orders for Life-Sustaining Treatment) Form
Download: Adobe PDF
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