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Free Arkansas Medical Power of Attorney Form

An Arkansas medical power of attorney names the agent who makes health care decisions when you lose capacity. Create yours with our guided form and choose between notarizing or using two witnesses.

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  • E-sign included

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What Is a Medical Power of Attorney in Arkansas?

Arkansas calls this document a durable power of attorney for health care. Under the Arkansas Healthcare Decisions Act, it authorizes your agent to make any health care decision you could make yourself, and it stays in effect after you lose capacity.

What the Arkansas Healthcare Decisions Act Requires

The core rules are in Arkansas Code § 20-6-103, which was updated in 2017.

Who Can Sign One

Adults can sign, and so can married minors and emancipated minors.

Put It in Writing

Your document must be written and signed by you. It can also include a living will or other instructions in the same packet.

Choose a Notary or Two Witnesses

You can have the document notarized, or you can sign in front of two witnesses. Each witness must be a competent adult who is not your agent.

At Least One Witness Must Be Independent

If you use witnesses, at least one of them cannot be related to you by blood, marriage, or adoption. That witness also cannot be someone who would inherit from you under a will or by law.

Witnessed Documents Need an Attestation Clause

A witnessed Arkansas medical power of attorney must contain an attestation clause stating that the witnesses meet these rules.

Does an Arkansas Medical Power of Attorney Need a Notary?

No, a notary is one of two options in Arkansas, not a requirement. The other option is two qualified witnesses plus the attestation clause described above.

The notary route saves you from checking each witness’s family ties and inheritance rights. Either route is equally valid for an Arkansas medical power of attorney under § 20-6-103.

Nobody Can Require You to Sign One

Arkansas bars health care providers, insurers, and health plans from requiring you to sign or revoke an advance directive as a condition of coverage or care. Signing is always your choice.

How to Sign Your Arkansas Medical Power of Attorney

Complete your Arkansas medical power of attorney form in this order:

  1. Name your agent and any backups.
  2. Add instructions about treatments you want or refuse, if any.
  3. Decide whether you will notarize or use two witnesses.
  4. For witnesses, confirm neither is your agent and at least one is unrelated and not an heir.
  5. Make sure the document includes a witness attestation clause if you go the witness route.
  6. Sign in front of the notary or both witnesses, and share copies with your agent and doctors.

What to Include in Your Arkansas Form

The Arkansas Board of Health adopted state health care decision forms in 2013, including an Appointment of Health Care Agent form. You are not limited to it, though. A complete document usually covers:

  • Your agent and alternates
  • Any individual instructions or a living will
  • An optional nomination of a guardian, which Arkansas allows
  • When your agent’s authority begins

By default, your agent’s authority starts only when a licensed physician determines you lack capacity. It stops again if you recover. Your agent follows your instructions first, then your best interest and personal values. Their decisions take effect without court approval.