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Free Washington DC Medical Power of Attorney Form

A Washington DC medical power of attorney is a durable power of attorney for health care under the DC Code. Build yours with our guided form, which includes the wording District law asks for.

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  • E-sign included

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What Is a Medical Power of Attorney in Washington DC?

Washington DC is not a state, and it runs on the DC Code rather than a state code. Under D.C. Code § 21-2205, a competent adult may designate in writing someone to make health-care decisions if they become unable to make or communicate a choice.

Washington DC Rules Under D.C. Code § 21-2205

The District’s rules are short but specific.

Your Signature and the Date

You sign your Washington DC medical power of attorney and write the date on it.

Two Adult Witnesses

Two adult witnesses also sign, affirming you were of sound mind and free from duress. The witnesses cannot include you, your health-care provider, or an employee of your health-care provider.

One Independent Witness

At least one witness must not be related to you by blood, marriage, or adoption. That witness also must not be entitled to any part of your estate by a current will or by law.

Older Documents

A durable power of attorney for health care signed before March 16, 1989 that specifically covers decisions after incompetency is effective if its execution meets the current rules.

What Wording Does a Washington DC Medical Power of Attorney Need?

You need two pieces of wording. First, the document must clearly communicate that you intend your attorney in fact to have authority over health-care decisions.

Second, it must include language identical or substantially similar to one of these sentences:

  • “This power of attorney shall not be affected by the subsequent incapacity of the principal.”
  • “This power of attorney becomes effective upon the incapacity of the principal.”

The first keeps authority in place after you lose capacity. The second makes it start only then.

No Notary Needed

Section 21-2205 lists two adult witnesses as the signing requirement and does not add a notary step. Spend your effort choosing witnesses who clear the provider and relative rules.

How to Sign Your Washington DC Medical Power of Attorney

Finish your Washington DC medical power of attorney form with this sequence:

  1. Name your attorney in fact and a backup.
  2. Include clear language granting health-care decision authority.
  3. Add one of the two durability sentences the DC Code specifies.
  4. Choose two adult witnesses who are not your providers or their employees.
  5. Date and sign, then have both witnesses sign and affirm.
  6. Hand copies to your attorney in fact, your backup, and every doctor you see regularly.

What Your Washington DC Form Must Include

Because the DC Code specifies wording for a Washington DC medical power of attorney, those sentences are the most important part of the document. A complete Washington DC health care power includes:

  • Your attorney in fact and any successor
  • A clear statement that the attorney in fact may make health-care decisions for you
  • One of the two durability sentences from § 21-2205(b)
  • Any limits or instructions you want
  • The date, your signature, and two witness signatures with affirmations

Authority applies when you become unable, by reason of mental disability, to make or communicate a choice about a particular decision.