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The New Jersey Medical Power of Attorney or “proxy directive” is the state-issued legal instrument used to nominate a representative to make health care decisions on behalf of another. The provided form is classified as durable because it will allow the designated agent to make selections regarding medical treatments if the principal party is deemed incapacitated. The common agreement is beneficial as a precautionary measure, securing one’s wishes as to who will be responsible for determining the best course of action to take when the patient cannot communicate with physicians.
Laws
Definition – “Proxy directive” means a writing which designates a health care representative in the event the declarant subsequently lacks decision-making capacity (§ 26-2H-55).
Signing Requirements – Review and attestation from two (2) subscribing witnesses or a notary is necessary (§ 26-2H-56).
Revocation – § 26-2H-57
Other Versions
New Jersey Medical Power of Attorney Form – Version 1
Download: Adobe PDF
Additional Resources
- Cooper University Health Care – Advance Directives and Living Wills
- Middlesex County Govt. Website – What is an Advance Directive for Health Care?
- NJ Health Care Quality Institute – Conversations of Your Life Brochure (also available in Spanish/en Español)
- State of New Jersey Dept. of Health – Frequently Asked Questions
- State of New Jersey Dept. of Health – POLST Brochure
Related Forms (4)
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- POLST Form
- Psychiatric Advance Directive
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Practitioners Orders for Life-Sustaining Treatment (POLST) (also available in Spanish/en Español)
Download: Adobe PDF
Psychiatric Advance Directive (also available in Spanish/en Español)
Download: Adobe PDF
Instructions/Information: Adobe PDF
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