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Free North Dakota Medical Power of Attorney Form

A North Dakota medical power of attorney is part of a health care directive, where you appoint a health care agent. Answer our questions to build yours and choose how your signature is verified.

  • 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 North Dakota?

North Dakota uses a single health care directive under North Dakota Century Code chapter 23-06.5. A 2005 rewrite folded the older treatment declarations into this one document, which can hold instructions, a health care power of attorney, or both.

North Dakota Health Care Directive Requirements

Section 23-06.5-05 lists what makes a directive legally sufficient.

The Basics

Your directive must:

  • Be in writing
  • Be dated
  • State your name
  • Be signed by you, or by someone you authorize, while you have capacity
  • Include health care instructions, a health care power of attorney, or both

Notary or Two Witnesses

Your signature on a North Dakota medical power of attorney must be verified by a notary public or by at least two witnesses who are 18 or older.

Provider Limits on Witnesses

At least one witness cannot be a health care or long-term care provider giving you direct care, or that provider’s employee.

Can a Nursing Home Employee Notarize a North Dakota Medical Power of Attorney?

Yes. North Dakota lets a notary who works for a health care or long-term care provider giving you direct care verify your signature. That makes it easier to finish the document in a facility.

Witnesses are treated more strictly. If you use two witnesses instead, at least one must be independent of your direct-care provider. Neither route requires you to hire a lawyer, though one can help if your situation is complex.

Some Decisions Still Need a Court

Even with a North Dakota medical power of attorney, your agent cannot consent to certain things without a court. These include admission to a mental health facility or state institution for more than 45 days, psychosurgery, abortion, or sterilization.

How to Sign Your North Dakota Medical Power of Attorney

Work through these steps for your North Dakota medical power of attorney form:

  1. Write your name and date the directive.
  2. Name the person who will decide for you, plus a backup.
  3. Add health care instructions, if you want them.
  4. Choose a notary or two adult witnesses.
  5. Make sure at least one witness is not your direct-care provider or its employee.
  6. Sign, then share copies with your agent and care team.

What to Include in Your North Dakota Form

A complete North Dakota health care directive usually includes:

  • Your name and the date
  • Your health care agent and alternates
  • Treatment instructions and values
  • The signature verification block for your notary or witnesses

Your agent should know where the signed original is kept, and your doctor should have a copy in your chart. Because the 2005 law combined North Dakota’s older documents into one directive, review any pre-2005 declaration you still have and consider replacing it.