Illinois Medical Power of Attorney Form

Illinois Medical Power of Attorney Form

Last updated October 27th, 2021

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An Illinois medical power of attorney allows a person to appoint a health care agent who is given the authority to make medical decisions on their behalf if they are incapacitated. The principal will need to communicate their health care preferences to the agent so that they will be able to carry out the principal’s instructions when the power of attorney becomes active. At least one (1) successor agent should also be named in case the first one is unavailable when they are needed.

Agent’s Duties755 ILCS 45/4-7

Laws Article IV (Powers Of Attorney For Health Care)

Signing Requirements (755 ILCS 45/4-5.1) – One (1) Witness

Statutory Form 755 ILCS 45/4-10(b)


State Definition

Statute755 ILCS 45/4-4(e-5)

“Health care agent” means an individual at least 18 years old designated by the principal to make health care decisions of any type, including, but not limited to, anatomical gift, autopsy, or disposition of remains for and on behalf of the individual.