Medical Power of Attorney


  • ... as my agent to make any and all healthcare decisions for my pet, except to the extent I state otherwise in this document. My agent shall follow my wishes as set forth through this document or other means. If my agent cannot determine the choice I would want for my pet, then my agent's decision shall be based upon what he or she believes to be in my pet's best interest. This medical power of attorney also takes effect if I become unable to make healthcare decisions for my pet and this fact is certified in writing.

  • I understand that this power of attorney revokes any prior medical power of appointment and shall exist indefinitely from the date I execute this document unless I establish a shorter time or revoke the power of attorney. If I am unable to make healthcare decisions for my pet and this power of attorney expires, the authority I have granted to my agent shall continue to exist until the time I am able again to make healthcare decisions for my pet.
  • Date Format: MM slash DD slash YYYY
  • If the person designated as my agent in unable or unwilling to make healthcare decisions for my pet, i designate the following alternative person to serve as my agent to make healthcare decisions for my pet as authorized by this document.

  • I hereby sign my name to this medical power of attorney.
  • Date Format: MM slash DD slash YYYY