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1. www.mass.gov › doc › download-the-massachusetts-healthcare-proxy-formMASSACHUSETTS HEALTH CARE PROXY FORM

   www.mass.gov › doc › download-the-massachusetts-healthcare-proxy-form

   Download and print the official form to appoint a health care agent and an alternate agent in Massachusetts. The form includes instructions, limitations, and statements for the principal, the agent, and the witnesses.

2. www.massgeneral.org › assets › mghMASSACHUSETTS HEALTH CARE PROXY - Massachusetts General Hospital

   www.massgeneral.org › assets › mgh

   Download and print a copy of the official Health Care Proxy form for Massachusetts, or order a packet with more information and a user's guide. Learn how to name a Health Care Agent and Alternate Agent, and what they can do for you if you are unable to make health care decisions.

3. www.massmed.org › healthcareproxyHealth Care Proxy Information and Forms - Massachusetts Medical...

   www.massmed.org › healthcareproxy

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   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.

4. www.bmc.org › sites › defaultMASSACHUSETTS HEALTH CARE PROXY - Boston Medical Center

   www.bmc.org › sites › default

   MASSACHUSETTS HEALTH CARE PROXY. OU. B. ____/____/____ 1. I, (Principal -- PRINT your name) , residing at. (Street) appoint as my Health Care Agent: (City or Town) (Name of person you choose as Agent) (State) of. (Street) (City/town) (State) (Phone) . ( OPTIONAL: If my Agent is unwilling or unable to serve, then I appoint as my Alternate Agent:

5. www.childrenshospital.org › sites › defaultMassachusetts Health Care Proxy Information and Form

   www.childrenshospital.org › sites › default

   The Massachusetts Health Care Proxy law (Massachusetts General Laws, Chapter 201D) authorizes a competent adult who is age eighteen or older to appoint a Health Care Agent. Your agent will have full authority to make any healthcare decisions, when you are unable to make or communicate those decisions.

6. www.massmed.org › patient-care › health-topicsMASSACHUSETTS HEALTH CARE PROXY

   www.massmed.org › patient-care › health-topics

   The Health Care Proxy is a simple legal document that allows you to name someone you know and trust to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions.

7. www.massmed.org › Physician_Focus › mass_health_care_proxy_2010revMASSACHUSETTS HEALTH CARE PROXY Information, Instructions, and...

   www.massmed.org › Physician_Focus › mass_health_care_proxy_2010rev

   The Health Care Proxy is a simple legal document that allows you to name someone you know and trust to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions.