Medical Power of Attorney

This power of attorney authorizes another person (your agent) to make your medical decisions for you (the principal). Your agent will be able to make decisions and act with respect to your medical treatment whether or not you are able to act for yourself. The meaning of and authority over subjects listed on this document is explained in the “Uniform Power of Attorney Act,” Part 7 of Article 14 of Title 15, of the Colorado Revised Statutes.

This power of attorney does not authorize the agent to make financial decisions for you.

You should select someone you trust to serve as your agent. Unless you specify otherwise, generally the agent’s authority will continue until you die, revoke the power of attorney, the agent resigns, or the agent is unable to act for you.

Your agent is entitled to reasonable compensation unless you state otherwise in the special instructions.

This form provides for the designation of one agent. If you wish to name more than one agent you should understand that Coagents are not required to act together unless you include that requirement in the special instructions.

If your agent is unable or unwilling to act for you, your power of attorney will end unless you have named a successor agent. You may also name a second successor agent.

This power of attorney becomes effective immediately unless you state otherwise in the special instructions.

  • Financial/General POA Declarant Information

  • Person granting authority
  • This field is for validation purposes and should be left unchanged.