General Information Regarding Durable Power Of printable pdf download

GENERAL INFORMATION REGARDING DURABLE POWER OF ATTORNEY

FOR HEALTH CARE

“Health care’ means any care, treatment, service, or procedure to maintain, diagnose, or

treat an individual’s physical or mental condition. Health care decisions also include

decisions about life-sustaining procedures, which means any medical procedure, treatment,

or intervention which utilizes mechanical or artificial means to sustain, restore, or

supplement a spontaneous vital function, and when applied to a person in a terminal

condition, would serve only to prolong the dying process. Life sustaining procedure does

not include administration of medication or performance of any medical procedure deemed

necessary to provide comfort care or to alleviate pain.

The following individuals shall not be designated as the attorney in fact to make health

care decisions under a durable power of attorney for health care:

1. a health care provider attending the principal on the date of execution;

2. an employee of such a health care provider unless the individual to be designated is

related to the principal by blood, marriage, or adoption within the third degree of

consanguinity.

The power of attorney for health care decisions may be revoked at any time and in any

manner by which the principal declarant is able to communicate the intent to revoke,

without regard to mental or physical condition. A revocation is only effective as to the

attending health care provider upon its communication to the provider by the principal

declarant or by another to whom the principal/declarant has communicated the revocation.

It is the responsibility of the principal declarant to provide the attending health care

provider with a copy of this document.

SUGGESTIONS AFTER FORM IS PROPERLY SIGNED, WITNESSED OR NOTARIZED

1. Provide a copy to the designated attorney-in-fact (agent) and to alternate

designated attorney-in-fact (if any).

2. Place original in a safe place known and accessible to family members or close friends.

3. Provide a copy to your doctor.

4. Provide a copy(s) to family member(s).

NOTE: For additional copies of this form, go to the Iowa Legal Aid Website (). You may go

directly to a pdf file of this document by putting in your browser.

General Information Regarding Durable Power Of