Medical Power of Attorney Vermont Form – Adobe PDF
The Vermont medical power of attorney form permits a resident to elect a health care surrogate who will execute their medical preferences while they are incapacitated and can no longer make competent decisions. The surrogate will be authorized to accept or deny health care treatments on the patient’s behalf. Such choices may include the refusal of life-prolonging treatments and artificial nutrition. The chosen surrogate may not be compensated for their actions other than reimbursement for basic expenses such as food, travel, and lodging. If the principal would like to setup a living will in addition to appointing a surrogate, then he or she should fill out the Advance Directive.
Signing Requirements – Two (2) Adult Witnesses (§ 9703)