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Download and print the official form to appoint a Health Care Agent and an alternate agent to make decisions for you if you are incapacitated. The form includes instructions, limitations, and statements for the principal, agent, and witnesses.
- Massachusetts law about health care proxies and living wills
Health care proxies and end of life care, Mass. Medical...
- Massachusetts law about health care proxies and living wills
Download a free form to name someone to make health care decisions for you if you are unable to do so. Learn about the responsibilities of a health care agent and how to revoke the form.
Download and print a copy of the official Massachusetts Health Care Proxy form, a legal document that allows you to appoint a health care agent. Learn how to fill out the form, what your agent can do, and how to revoke it.
10 wrz 2024 · Health care proxies and end of life care, Mass. Medical Society. Includes information on health care proxies, living wills, hospice, and more. Massachusetts medical orders for life-sustaining treatment (MOLST), Mass. Dept. of Public Health.
Health care organizations and others can contact Massachusetts Health Decisions, the nonprofit publisher of the form, for more information about purchasing or reproducing the form. The form is available in English and 15 other languages. Email: proxy@masshealthdecisions.org.
The Massachusetts Health Care Proxy is a simple legal form that allows you to name someone you trust to make health care decisions for you, according to your wishes, if—for any reason and at any time—you become unable to make or communicate those decisions yourself.
Statements of Health Care Agent and Alternate Agent (OPTIONAL) Health Care Agent: I have been named by the Principal as the Principal's Health Care Agent by this Health Care Proxy.
