Illinois Living Will Declaration Template (Page 7 of 8) in pdf

(Sec-10(b).) The statutory short form power of attorney for health care (the "statutory

health care power") authorizes the agent to make any and all health care decisions on

behalf of the principal which the principal could make if present and under no

disability, subject to any limitations on the granted powers that appear on the face of

the form, to be exercised in such manner as the agent deems consistent with the intent

and desires of the principal. The agent will be under no duty to exercise granted powers

or to assume control of or responsibility for the principal's health care; but when granted

powers are exercised, the agent will be required to use due care to act for the benefit of

the principal in accordance with the terms of the statutory health care power and will

be liable for negligent exercise.

The agent may act in person or through others

reasonably employed by the agent for that purpose but may not delegate authority to

make health care decisions. The agent may sign and deliver all instruments, negotiate

and enter into all agreements and do all other acts reasonably necessary to implement

the exercise of the powers granted to the agent. Without limiting the generality of the

foregoing, the statutory health care power shall include the following powers, subject to

any limitations appearing on the face of the form:

(1) The agent is authorized to give consent to and authorize or refuse, or to withhold

or withdraw consent to, any and all types of medical care, treatment or procedures

relating to the physical or mental health of the principal, including any medication

program, surgical procedures, life-sustaining treatment or provision of food and fluids

for the principal.

(2) The agent is authorized to admit the principal to or discharge the principal from

any and all types of hospitals, institutions, homes, residential or nursing facilities,

treatment centers and other health care institutions providing personal care or treatment

for any type of physical or mental condition. The agent shall have the same right to

visit the principal in the hospital or other institution as is granted to a spouse or adult

child of the principal, any rule of the institution to the contrary notwithstanding.

(3) The agent is authorized to contract for any and all types of health care services

and facilities in the name of and on behalf of the principal and to bind the principal to

pay for all such services and facilities, and to have and exercise those powers over the

principal's property as are authorized under the statutory property power, to the extent

the agent deems necessary to pay health care costs; and the agent shall not be personally

liable for any services or care contracted for on behalf of the principal.

(4) At the principal's expense and subject to reasonable rules of the health care

provider to prevent disruption of the principal's health care, the agent shall have the same

right the principal has to examine and copy and consent to disclosure of all the

principal's medical records that the agent deems relevant to the exercise of the agent's

powers, whether the records relate to mental health or any other medical condition and

whether they are in the possession of or maintained by any physician, psychiatrist,

psychologist, therapist, hospital, nursing home or other health care provider.

America Living Will Registry, LLC. • 2814 Beach Boulevard • St. Petersburg, FL 33707 • 1-866-305-ALWR •

Illinois Living Will Declaration Template Page 7