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North Carolina Medical Power of Attorney Form

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Updated on October 27th, 2021

North Carolina medical power of attorney is drafted by a principal to grant another person permission to make medical decisions on their behalf. The recipient of authority (the “health care agent”) will be responsible for communicating the principal’s end-of-life medical preferences when they are no longer able to make those decisions. In addition to this document, the principal may also wish to execute a Living Will which allows them to define their choices for life-sustaining treatment.

Agent’s Duties § 32A-19

Laws Chapter 32A, Article 3 (Health Care Powers of Attorney)

Signing Requirements (§ 32A-16(3)) – Two (2) Witnesses and Notary Public

Statutory Form § 32A-25.1


State Definition

Statute § 32A-16(3)

Health care power of attorney. – Except as provided in G.S. 32A-16.1, a written instrument that substantially meets the requirements of this Article, that is signed in the presence of two qualified witnesses, and acknowledged before a notary public, pursuant to which an attorney-in-fact or agent is appointed to act for the principal in matters relating to the health care of the principal.