Fillable Medical Power of Attorney Document for Tennessee State

A Tennessee Medical Power of Attorney form is a legal document that allows you to appoint someone you trust to make healthcare decisions on your behalf if you are unable to do so. This can cover a wide range of decisions, from treatment options to end-of-life care. Ensure your wishes are honored by filling out a Tennessee Medical Power of Attorney form today—click the button below.

Get Form Here

In the journey of life, moments arrive when one might not be able to make healthcare decisions for themselves, due to unforeseen circumstances. It's in these crucial times that the Tennessee Medical Power of Attorney form becomes an indispensable document. Functioning as a beacon of one's wishes, this form empowers a trusted individual to make healthcare decisions on behalf of someone who is incapacitated. This legal instrument covers a broad spectrum of decisions, ranging from treatment options to end-of-life care, ensuring that a person's healthcare preferences are honored, even when they cannot express them. Crafted with careful considerations, this form also serves as a guide for doctors and medical professionals, providing clarity and reducing the burden of making hard choices without knowing the patient's wishes. The process of appointing someone with this responsibility carries significant emotional and legal weight, necessitating a deep understanding of the form's elements, the rights it confers, and how it aligns with Tennessee's laws. By diving into this topic, individuals can prepare for the future with confidence, knowing their healthcare decisions are in trusted hands.

Contents

Tennessee Medical Power of Attorney Example

Tennessee Medical Power of Attorney

This Tennessee Medical Power of Attorney is a legal document that grants an individual (referred to as the "Agent") the power to make healthcare decisions on behalf of the signer (referred to as the "Principal"), in accordance with the Tennessee Durable Power of Attorney for Health Care Act.

Principal Information:

Full Name: _______________________________
Address: __________________________________
City, State, Zip: __________________________
Telephone Number: ________________________

Agent Information:

Full Name: _______________________________
Relationship to Principal: __________________
Address: __________________________________
City, State, Zip: __________________________
Telephone Number: ________________________
Alternate Telephone Number: _______________

Appointment of Health Care Agent

By this document, I, ____________________________ [Principal's Full Name], a resident of the State of Tennessee, hereby designate __________________________________ [Agent's Full Name], as my Attorney-in-Fact ("Agent") to make health care decisions for me as authorized in this document.

My Agent’s authority becomes effective when my attending physician certifies in writing that I lack the capacity to make or communicate health care decisions.

Powers of Health Care Agent

The powers granted to my Health Care Agent include, but are not limited to, the following:

To consent, refuse, or withdraw consent to any and all types of medical care, treatment, surgical procedures, diagnostic procedures, medication, and the use of mechanical or other procedures that affect any bodily function.
To request, receive, and review any verbal or written information regarding my physical or mental health, including medical and hospital records.
To make decisions regarding my participation in medical research or experimental treatment.
To make decisions about organ donation, autopsy, and the disposition of my body after death, in accordance with Tennessee state laws.

This Medical Power of Attorney will remain in effect until I revoke it or it is terminated by my death.

Signature

Principal's Signature: ___________________________ Date: _____________

Witness Signature: _____________________________ Date: _____________

Printed Name of Witness: ___________________________________________

Note: In accordance with Tennessee law, this document should be signed in the presence of a notary public or two (2) adult witnesses, who are not related to the Principal by blood, marriage, or adoption and are not directly financially responsible for the Principal's medical care.

⇓ PDF File

Form Overview

Fact Name	Description
Definition	A Tennessee Medical Power of Attorney allows an individual to designate another person to make healthcare decisions on their behalf should they become unable to do so.
Relevant Legislation	This form is governed by the Tennessee Uniform Durable Power of Attorney Act, specifically found in sections 34-6-201 through 34-6-220 of the Tennessee Code.
Agent's Authority	The designated agent gains the authority to make decisions regarding the principal's medical care, including treatment options and end-of-life care.
Requirements for Validity	The document must be signed by the principal and witnessed by at least one adult who is not the appointed agent, relative by blood or marriage, or entitled to any part of the estate of the principal upon death.
Durability	This power of attorney remains in effect even if the principal becomes incapacitated, ensuring decisions can be made according to the principal's wishes.
Revocation	The principal can revoke the power of attorney at any time, as long as they are mentally competent, through a written notice to the agent.
Agent's Obligations	The agent is obligated to act in the principal's best interest, following their wishes as stated in the document or otherwise made known.

Documents used along the form

In preparing for medical eventualities and ensuring one’s wishes are respected, the Tennessee Medical Power of Attorney form is an essential document. However, to fully prepare for various healthcare and legal scenarios, several other documents might be necessary. Each of these plays a crucial role in safeguarding an individual's healthcare preferences and legal rights.

Advance Directive: This document combines a living will and a durable power of attorney for healthcare, where one can specify their medical treatments preferences and appoint someone to make decisions on their behalf if they're unable to do so.
Last Will and Testament: Essential for outlining how one’s property and affairs should be handled after their death, including the distribution of assets and care of minors.
Living Will: This legal document allows individuals to outline their wishes regarding life-prolonging medical treatments in the event they become incapacitated and unable to communicate their healthcare preferences.
Durable Power of Attorney for Finances: Similar to the Medical Power of Attorney but for financial affairs, allowing someone to manage financial matters on one's behalf if they become incapacitated.
HIPAA Release Form: A critical document that authorizes healthcare providers to share your health information with individuals you designate, facilitating the management of your healthcare by others when necessary.
Do Not Resuscitate (DNR) Order: A medical order that tells healthcare providers not to perform CPR if breathing stops or the heart stops beating. It is used by individuals who do not want life-prolonging measures in the event of cardiac or respiratory arrest.
Organ Donor Form: Allows individuals to register their decision to donate their organs and tissues after death. This form is often included as part of state ID or driver’s license registration processes.
Funeral Directive: Outlines an individual's preferences for their funeral arrangements, including burial or cremation, service types, and specific instructions for carrying out these wishes.
Guardianship Appointment: A legal document that appoints someone to make decisions, both financial and healthcare-related, for a minor child or an incapacitated adult.

Gathering and completing these documents can offer peace of mind, knowing that one’s wishes will be respected and that their loved ones are legally empowered to act on their behalf. While it may seem daunting, each form serves a distinct and crucial role in comprehensive healthcare and estate planning.

Consider Some Other Medical Power of Attorney Templates for Specific States

Living Will Vermont - This document empowers your agent to communicate effectively with your health care providers, ensuring your plan is executed as intended.

How to Get Power of Attorney for Elderly Parent in Georgia - The possibility to specify religious, philosophical, or moral guidelines shapes the healthcare approach in alignment with the principal's beliefs.

Washington State Power of Attorney - Having a Medical Power of Attorney in place is a key component of a comprehensive estate plan.

Living Will Form Rhode Island - It often complements a living will, where one outlines their wishes concerning life-prolonging treatments.