Medical Power of Attorney Missouri Form – PDF

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A Missouri medical power of attorney form grants a third party the authority to act as an individual’s health care agent to make all decisions regarding their health care if they become incapacitated. In the contract, the individual being represented (the principal) can stipulate whether the agent will be permitted to determine the use of certain life-sustaining medical treatments.

The “Health Directive” portion of the form is optional and can be used to specify any medical procedures that are to be withdrawn if the principal is in critical condition or has persistent unconsciousness. It is important to note that the agent cannot be the principal’s physician or anyone involved in their health care unless they are related by blood or members of the same precisely defined religious community.

Laws§ 404.800 to § 404.865 (Durable Power of Attorney for Health Care Act)

Signing Requirements (§ 404.705(3)) – Notary Public