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Indiana Medical Power of Attorney Form

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The Indiana medical power of attorney is used by the principal to appoint a health care representative who is given the authority to decide when to remove or withhold life-sustaining treatments if the principal is incapacitated. Appointing a health care representative allows the principal to ensure that the individual selected to oversee their end-of-life care is someone they know and trust. In the event of the principal’s incapacitation, the power of attorney becomes active and the representative is empowered to make medical decisions on the principal’s behalf.

Agent’s DutiesIC 16-36-1-7(g)

Laws IC 16-36-1-7

Signing Requirements (IC 16-36-1-6(a)(3), IC 16-36-1-7(b)(3)) – One (1) Witness


State Definition

StatuteIC 16-36-1-2

“representative” means:

(1) an individual at least eighteen (18) years of age;
(2) a corporation;
(3) a trust;
(4) a limited liability company;
(5) a partnership
(6) a business trust;
(7) an estate;
(8) an association;
(9) a joint venture;
(10) a government or political subdivision;
(11) an agency;
(12) an instrumentality; or
(13) any other legal or commercial entity;
appointed to consent to health care of another under this chapter.