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Free Hawaii Medical Power of Attorney Form

A Hawaii medical power of attorney lets you appoint an agent to make health-care decisions if you lose capacity. Build yours with our customizable template and choose the signing method that suits you.

  • Download as PDF and Word
  • E-sign included

How It Works

1

Select Your Template

Choose the state or form type you need to start.

2

Fill In Your Details

Answer a few simple questions to customize your form.

3

Get Your Form

Download or print your custom document in PDF or Word.

What Is a Medical Power of Attorney in Hawaii?

Hawaii calls this document a power of attorney for health care, one type of advance health-care directive under Chapter 327E of the Hawaii Revised Statutes. It lets your agent make any health-care decision you could have made yourself, and it stays in effect after you lose capacity.

Hawaii Requirements, Step by Step

Section 327E-3 sets out who can sign and how the document must be witnessed.

Emancipated Minors Can Sign Too

Adults can create a Hawaii medical power of attorney. So can emancipated minors.

Write, Date, and Sign It

The document must be in writing, contain the date you sign it, and bear your signature.

Pick Witnesses or a Notary

Use one of two methods:

  • At least two witnesses, each of whom sees you sign or hears you acknowledge your signature
  • A notary public, with the acknowledgment made anywhere within Hawaii

Who Cannot Witness

A witness cannot be a health-care provider, an employee of a health-care provider or facility, or your agent. At least one witness also must be someone who is not related to you and would not inherit from you under a will or by law.

Facility Owners and Staff as Agents

An owner, operator, or employee of the institution where you receive care cannot be your agent. The exception is someone related to you by blood, marriage, or adoption.

How Do You Revoke a Hawaii Medical Power of Attorney?

You revoke the agent designation with a signed writing or by personally telling your supervising health-care provider. Other parts of the directive, such as treatment instructions, can be revoked at any time and in any way that shows your intent.

A few changes happen automatically. A divorce, annulment, dissolution, or legal separation decree revokes a spouse’s designation as agent, unless the decree or your document says otherwise. A newer directive also revokes an older one to the extent the two conflict.

Tell Your Provider About Changes

A health-care provider, agent, guardian, or surrogate who learns you revoked your directive must promptly tell your supervising health-care provider and the facility treating you. Still, the fastest fix is to tell your provider yourself and hand them the updated document.

How to Sign Your Hawaii Medical Power of Attorney

These steps help you complete your Hawaii medical power of attorney form:

  1. Name your agent and at least one alternate.
  2. Write any treatment instructions or limits you want your agent to follow.
  3. Choose between two witnesses and a Hawaii notary.
  4. Confirm neither witness is a provider, a provider’s or facility’s employee, or your agent.
  5. Date and sign the document.
  6. Share copies with your agent, your alternate, and your primary physician.

What to Include in Your Hawaii Form

A clear Hawaii medical power of attorney usually covers:

  • Your agent and alternates
  • Individual instructions about treatments you want or refuse
  • Whether your agent’s authority starts right away or only after you lose capacity
  • An optional guardian nomination, which Hawaii allows

Unless your document says otherwise, your primary physician decides whether you lack capacity. Your agent’s authority begins then and stops if you recover. Your agent follows your instructions and known wishes first, and their decisions need no court approval. Hawaii also accepts a directive signed in another state if it met that state’s law when signed.