The Arizona Health Care Power of Attorney Form allows an individual to identify a second party they would like to operate on their behalf should they become too sick to discuss their requests concerning medical treatment. When choosing an attorney-in-fact, it is crucial that the principal makes sure that they can rely on the party they appoint, otherwise, they may select a person that does not have their best interest. To activate the arrangement, the transferor of powers should supply the document with any desired instructions, the agent’s contact info, and their endorsement for the exchange of rights. (This form demands that the signing occurs under the observation of a witnessing party or an official who can notarize the document.)

Other Versions (3)

• ALWR Version
• Dignity Health Version
• Spanish Version

America Living Will Registry Version

Download: Adobe PDF

 

 

 

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Dignity Health Version (also available in Spanish/en Español)

Download: Adobe PDF

 

 

 

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Spanish Version

Download: Adobe PDF

 

 

 

Additional Resources

• Arizona Dept. of Economic Security – Decisions About Your Health Care Guide
• Arizona Hospital and Healthcare Association – Advance Care Planning
• Health Current – Arizona Healthcare Directives Registry
• Hospice of the Valley – Health Care Decisions FAQs

Related Forms (5)

• Advance Directive
• Advance Directive Wallet Card
• Durable (Financial) Power of Attorney Form
• Health Care Directive Registration Agreement
• Health Care Power of Attorney for a Minor

Advance Directive

Download: Adobe PDF

 

 

 

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Advance Directive Wallet Card

Download: Adobe PDF

 

 

 

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Durable (Financial) Power of Attorney

Download: Adobe PDF

 

 

 

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Health Care Directive Registration Agreement

Download: Adobe PDF

 

 

 

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Health Care Power of Attorney for a Minor

Download: Adobe PDF
Information: Adobe PDF