Document Genius

Free Massachusetts Medical Power of Attorney Form

A Massachusetts medical power of attorney is called a health care proxy, and it names the agent who decides when you cannot. Fill in our guided form, then sign it with two adult witnesses.

  • 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 Massachusetts?

Massachusetts calls this document a health care proxy under General Laws chapter 201D. Every competent adult has the right to appoint a health care agent this way.

Massachusetts Health Care Proxy Rules

Section 2 of chapter 201D sets out how to sign.

Two Adult Witnesses

You sign your Massachusetts medical power of attorney in the presence of two other adults, who also sign as witnesses. Someone else can sign for you at your direction.

Witnesses Affirm in Writing

Your witnesses affirm in writing that you appeared to be at least 18, of sound mind, and under no constraint or undue influence.

Your Agent Cannot Witness

Anyone named as health care agent in the proxy cannot act as a witness.

An Alternate Agent Can Step In

You may name an alternate. That person serves when your first agent is unavailable, unwilling, or not competent to make a timely decision, or is disqualified.

Proxies Are Presumed Valid

Adults are presumed competent, and every proxy is presumed properly executed unless a court determines otherwise.

Can You Overrule Your Agent in Massachusetts?

Yes. Even after a doctor finds you lack capacity, your objection to a decision made by your agent prevails. The exception is when a court order determines you lack capacity to make health care decisions.

This protection makes a Massachusetts medical power of attorney less of an all-or-nothing handover. Your agent speaks for you, but a doctor’s finding alone does not override your objection.

The Capacity Finding Must Be in Writing

Your agent’s authority begins only after your attending physician determines, in writing, that you cannot make or communicate health care decisions. The note must cover the cause, nature, extent, and probable duration of the incapacity. A physician who is also your agent cannot make that call.

How to Sign Your Massachusetts Medical Power of Attorney

Complete your Massachusetts medical power of attorney form as follows:

  1. Name your health care agent and, if you want, an alternate.
  2. Add any limits on your agent’s authority.
  3. Bring two adults who are not named as agents.
  4. Sign the proxy while both witnesses watch.
  5. Have each witness sign and affirm your age, sound mind, and lack of pressure.
  6. Give copies to your agent, alternate, and doctors.

What to Include in Your Massachusetts Form

Chapter 201D has a section on the contents of a proxy, but the core is simple. A clear document names:

  • Your health care agent
  • An alternate agent, if you choose one
  • Any limits you place on the agent’s authority

If you regain capacity, your agent’s authority stops and your own consent is needed again. It restarts if you later lose capacity.

When a doctor finds you lack capacity, Massachusetts requires prompt notice, both orally and in writing. It goes to you if you can understand it, to your agent, and to the facility director if you are in a mental health facility. If the incapacity stems from mental illness or a developmental disability, the doctor must have, or consult someone with, specialized training in that area.