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What is a Mental Health Power of Attorney?
A mental health power of attorney is a legal document that grants permission to a chosen individual or organization to make mental health decisions for you, such as B. Accepting you into a facility and refusing or accepting certain treatments.
The person granting control is referred to as the "principal" and the individuals or organizations to whom the powers are delegated are referred to as "agents". Rocket Lawyer's Mental Health Power of Attorney Forms are designed for all US citizens and can be fully customized to suit your specific scenario. This official document allows your representative to confirm to healthcare providers and other parties that they can legitimately act on your behalf when you cannot.
When to use a Power of Attorney:
- You want to appoint someone to make decisions about your mental health care when you can't do it yourself.
- Expect treatment in a psychiatric facility.
- Your mental health is deteriorating or you have been diagnosed with a medical condition that may prevent you from making decisions about your mental health.
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Mental health power of attorney template
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POWER OF ATTORNEY FOR MENTAL HEALTH CARE
EU,, who is authorized to make mental health decisions, I authorize my designated health officer to make certain decisions related to my mental health care on my behalf. If I have not expressed my decision in this document, I authorize my agent to make the decision that he or she would, in his or her discretion, make if I had the authority to do so.
I understand that mental health care includes any care, treatment, service, or procedure for the maintenance, diagnosis, treatment, or delivery of mental health, including any drug and therapeutic treatment programs. Electroconvulsive therapy may only be carried out if I have expressly consented to it here. I will not be subjected to laboratory or research testing unless expressly provided for in this document. Psychiatric care does not include psychosurgery or termination of parental rights.
I understand that my disability will be determined through an examination by a psychiatrist and one of the following: another psychiatrist, psychologist, family doctor, treating physician or psychotherapist. Whenever possible, one of the decision makers will be one of my customer service representatives.
A. AGENT DESIGNATION.
I hereby appoint and designate the following person as my agent to make mental health decisions for me as authorized herein:
| Signed: |
____________________________________
,
| Landline phone: | working cell phone: |
| Testified by: |
| ___________________________________ | ____________________________________ |
| , |
| Agent Acceptance: |
| I accept appointment as psychiatrist for. |
| Agent Signature: |
| ____________________________________ |
,
B. APPOINTMENT OF AN ALTERNATIVE REPRESENTATIVE.
In the event that my primary caregiver is unavailable or unable to serve as my mental health caregiver, I designate and appoint the following person as my alternate mental health caregiver to make health care decisions for me as herein authorized:
| Signed: |
____________________________________
,
| Landline phone: | working cell phone: |
| Testified by: |
| ____________________________________ | ____________________________________ |
| , |
| Agent Acceptance: |
| I accept appointment as psychiatrist for. |
| Agent Signature: |
| ____________________________________ |
,
C. WHEN THIS POWER OFFICE COMES INTO EFFECT.
This power of attorney comes into effect
D. AUTHORITY GRANTED TO MY MENTAL HEALTH CARE AGENT.
I hereby grant my agent all powers and authority to make mental health decisions for me, subject to the instructions and limitations set forth in this Power of Attorney. If I have not expressed my choice in this Power of Attorney, I authorize my agent to make the decision that he or she would in his or her discretion make if I had the authority to do so.
E. TREATMENT PREFERENCES.
1. Preferences regarding drugs for psychiatric treatment.
2. Electroconvulsive therapy (ECT) preferences.
3. Preferences for experimental studies or drug testing.
F. WITHDRAWAL.
This power of attorney can be revoked in whole or in part at any time, verbally or in writing, unless I am classified as mentally incapable of making decisions.
My withdrawal will be effective when I, or a witness to my withdrawal, notify my treating physician or other mental health professional of my intention to withdraw. If I elect to revoke any particular instruction in this Power of Attorney in the manner specified, I understand that the other instructions contained in this Power of Attorney will remain in effect until:
(1) I revoke this power of attorney in its entirety;
(2) issue a new mental health power of attorney; any
(3) two years from the date of signing this document.
G. TERMINATION.
I understand that this power of attorney will automatically expire two years from the date of signing, unless I am deemed unable to make mental health decisions at the time the power of attorney expires.
The appointment of my guardian does not give the guardian authority to revoke, suspend, or terminate this power of attorney.
By appointing a guardian, I authorize the guardian to revoke, suspend, or terminate this power of attorney.
I grant this power of attorney.
| My signature: |
____________________________________
district
,
Landline phone:working cell phone:
| Testified by: |
| ____________________________________ | ____________________________________ |
| , |
_____(Your deputy)
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Mental Health Power of Attorney Frequently Asked Questions
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Can I get a mental health power of attorney form online for free?
Rocket Lawyer's free mental health power of attorney template makes it quick and easy to assign or receive the support you need:
- make your document- Answer a few simple questions and we'll do the rest
- send and share- Check with your agent or seek legal help
- Sign and make it legal- Optional or not, witnesses/notarization recommended
In many cases, this method is significantly cheaper than finding and working with a conventional lawyer. If required, you can fill out this Medical PoA on behalf of your spouse or another relative and then have it signed once it is written. Please note that the Power of Attorney must be a competent adult at the time of signing for a Power of Attorney to be valid. If the client has already been found to be legally incompetent, a court-appointed guardianship can be demanded. In such a situation it would be importanttalk to a lawyer.
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Do I need to have a Mental Health PoA?
Every adult must have a power of attorney. While it can be painful to admit, there may come a time when you cannot make your own medical decisions. Typical occasions when you might find a PoA useful include:
- You are getting older or have health problems
- You live in a care center or intend to move there
- You are at risk of medical intervention or hospitalization.
- You are dealing with an incurable disease.
Whether this mental health power of attorney was created as part of a long-term plan or in response to an unexpected emergency, the presence of witnesses and/or notarization is highly recommended to protect your document if a third party challenges its legality in question asks . . . .
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Is there a difference between a Power of Attorney for Mental Health Care and a Power of Attorney for Mental Health Care?
When discussing elder care or estate planning with a healthcare or legal professional, the terms “healthcare power of attorney” and “healthcare power of attorney” may be used together. In reality they are one and the same. However, you should be aware that it is possible to obtain a power of attorney for non-health related matters, although 'representation' is not usually the term of choice.
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Do I need to work with an attorney to review my medical PoA?
Mental health PoA forms are generally easy to fill out, but you or your representative may need legal advice. Finding a lawyer to review your document can be time consuming when trying to do it yourself. A simpler approach to consider is Rocket Lawyer On Call®Rocket Lawyer network members can request a document review from an attorney with relevant experience or ask additional questions. As always, rest easy knowing Rocket Lawyer has your side.
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How much would it typically cost to get a mental health power of attorney?
The cost of working with a law firm to obtain a mental health power of attorney can range from $200 to $500, depending on your location. Rocket Lawyer is not your average power of attorney template site. With us, anyone with a Premium subscription can save up to 40% when hiring a lawyer from the Rocket Lawyer network.
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After receiving a mental health power of attorney, do I need to do anything else?
Attached to each power of attorney form is a list of suggested actions to be taken to complete your document. We encourage you to try some or all of the following actions on your document: edit, download, print, and/or sign. Finally, you must provide a copy of the fully signed document to your representative(s), healthcare providers and other concerned parties.
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Does a Mental Health Power of Attorney need to be notarized, authenticated and/or registered?
The specific requirements and restrictions for PoA forms vary from state to state; However, it is recommended that you have your power of attorney notarized and/or signed by at least one witness to demonstrate the credibility of the document. Finally, as a general rule, witnesses must not be under the age of 18 and no witness may be named as your PoA agent at the same time.
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