Modify Form Now

Fillable Tennessee Medical Power of Attorney Document

The Tennessee Medical Power of Attorney form is a legal document that allows you to designate someone to make healthcare decisions on your behalf if you become unable to do so. This important form ensures that your medical preferences are honored, providing peace of mind for you and your loved ones. To take the next step in preparing for your future, consider filling out the form by clicking the button below.

Modify Form Now

Table of Contents

When it comes to making important healthcare decisions, having a plan in place can provide peace of mind. In Tennessee, a Medical Power of Attorney form is a crucial document that allows you to designate someone you trust to make medical decisions on your behalf if you become unable to do so. This form not only empowers your chosen agent to communicate with healthcare providers but also ensures that your medical preferences are honored, even when you cannot express them yourself. By outlining your wishes regarding treatment options, life support, and other critical healthcare matters, you can guide your agent in making choices that reflect your values and desires. Additionally, understanding the legal requirements for completing and executing this form is essential, as it ensures that your document will be recognized and respected by medical professionals. Whether you are planning for the future or responding to a current health concern, a Medical Power of Attorney is an important step in taking control of your healthcare journey.

Tennessee Medical Power of Attorney Sample

Tennessee Medical Power of Attorney

This document grants authority to a chosen individual to make medical decisions on behalf of the person creating the document, in accordance with the Tennessee Durable Power of Attorney for Health Care Act.

Principal Information

Full Name: ___________________________
Address: _____________________________
City, State, Zip: ______________________
Phone Number: ________________________
Date of Birth: ________________________

Agent Information

Full Name: ___________________________
Relationship to Principal: ______________
Address: _____________________________
City, State, Zip: ______________________
Phone Number: ________________________
Alternate Phone Number: _______________

Alternate Agent Information (if any)

Full Name: ___________________________
Relationship to Principal: ______________
Address: _____________________________
City, State, Zip: ______________________
Phone Number: ________________________
Alternate Phone Number: _______________

Authority of Agent:

The agent is hereby granted the authority to make any and all health care decisions for the principal that the principal could make if capable, including decisions about choosing or refusing life-sustaining treatment, except as the principal may limit in this document.

Limitations on Agent's Authority (if any):

__________________________________________________________

Effective Date and Signatures

This Medical Power of Attorney becomes effective upon the incapacitation of the principal, as determined by a physician.

Principal's Signature: _____________________
Date: _______________

Agent's Signature: _______________________
Date: _______________

Witnesses (Two required, not related by blood or marriage, not beneficiaries, not entitled to any part of the estate, and not healthcare providers of the principal):

Name: _____________________________
Signature: _________________________
Date: _______________
Name: _____________________________
Signature: _________________________
Date: _______________

This document revokes any prior Tennessee Medical Power of Attorney documents.

By signing this document, the Principal acknowledges their understanding of its contents and the powers being granted to the Agent. It is recommended that all parties consult with a healthcare professional and legal advisor when completing this form.

⇓ Medical Power of Attorney PDF Form

PDF Data

Fact Name	Details
Definition	A Tennessee Medical Power of Attorney form allows an individual to designate someone to make healthcare decisions on their behalf if they are unable to do so.
Governing Law	This form is governed by Tennessee Code Annotated, Title 68, Chapter 11, Part 1.
Eligibility	Any adult resident of Tennessee can create a Medical Power of Attorney.
Agent Requirements	The chosen agent must be at least 18 years old and cannot be the individual's healthcare provider or an employee of the healthcare provider.
Execution Requirements	The form must be signed by the principal in the presence of two witnesses or a notary public.
Revocation	The principal can revoke the Medical Power of Attorney at any time, provided that they are mentally competent to do so.

Please rate Fillable Tennessee Medical Power of Attorney Document Form

4.7

(Stellar)

20 Votes

Additional Tennessee Templates

Non Disclosure Agreement - An effectively executed NDA can make the difference in maintaining the competitive edge and operational security of a business.

The FedEx Bill of Lading form is an essential shipping document that not only provides details about the transport of goods but also serves as a contract between the shipper and the carrier. It outlines responsibilities and requirements for the shipment, making it vital to understand how to fill out this form correctly to streamline the shipping process and avoid complications. For those looking for templates to assist in this process, PDF Templates Online offers valuable resources.

Free Tennessee Power of Attorney Form - With the durable power of attorney, individuals can specify which powers their appointed agent will have in managing their affairs.

Tennessee Premarital Agreement - By detailing what happens to each partner's assets, it helps simplify the legal aspects of a potential divorce.