Free Printable Connecticut Medical Power of Attorney Form

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This Connecticut Medical Power of Attorney Form can be used to appoint someone else to make medical decisions on your behalf in the event that you are unable to make the decisions for yourself. In Connecticut the medical power of attorney is called an Appointment of Health Care Representative. It is your responsibility to accurate complete the Connecticut Medical Power of Attorney Form and ensure that it is witnessed or notarized if required by state law.

The Connecticut Medical Power of Attorney is remarkably uncomplicated to fill out. Just about all of the time required will be figuring out in advance which preferences you want performed if or when the time takes place. Do you want to stay on life support systems even if there is no brain activity? Do you want medical doctors trying to revive you if you enter into heart attack? Do you want to donate your organs and tissues after you’ve passed away? The most beneficial time to make these agreements is when you’re somewhat healthy and in a clear state of mind.

It is imperative that you explain your decisions to the person you are appointing as your medical representative. The individual positively needs to grasp what your preferences are for as many likely scenarios as possible. For how long do you wish to continue with life support prior to making the decision to discontinue life support? Do you have any worries of particular medical treatments or treatment plans? Do you wish to breath on your own at all times or is a breathing device suitable?

Example of Connecticut Medical Power of Attorney Form

Printable Connecticut Medical Power of Attorney Form

Select the appropriate file to download the cost-free Connecticut Medical Power of Attorney in Microsoft Word. You may also create the Connecticut Medical Power of Attorney Form using our free fillable PDF version. The PDF has fillable fields into which you can type the required information.

Printable Microsoft Word

Printable Connecticut Medical Power of Attorney Form Word

Printable PDF

Printable Connecticut Medical Power of Attorney Form PDF


This Connecticut medical power of attorney form as well as a great number of various other legal forms presented on this internet site are offered free “as is” without any intended or implied warranties. This also includes, yet is not limited to, warranty of merchantability or fitness for any type of type of specific use.

This Connecticut medical power of attorney form was not crafted by a legal representative or law practice. It is your obligation to determine if the document is properly suitable for your requirements. You need to furthermore make certain that the form is completed filled in and likewise notarized and/or witnessed if mandated.

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