Medical Power of Attorney Mississippi Form – PDF

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The Mississippi medical power of attorney form is used to name a health care agent to represent an individual in the event that they are incapacitated due to illness, injury, or old age. Most individuals choose their spouse, a close friend, or a relative to be their agent. The selected representative should be available locally and be trusted to advocate the principal’s views regarding medical treatments. The second (2nd) part of the form allows the principal to state which end-of-life medical procedure(s) they wish to permit if they are in an incurable vegetative state.

Laws§ 41-41-201 to § 41-41-229 (Uniform Health-Care Decisions Act)

Signing Requirements (§ 41-41-205(2)) – Two (2) Witnesses or a Notary Public