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Free Washington Medical Power of Attorney Form

A Washington medical power of attorney names an agent for health care decisions under the state's Uniform Power of Attorney Act. Complete it with our step-by-step questionnaire and choose a notary or two witnesses.

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  • E-sign included

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What Is a Medical Power of Attorney in Washington?

In Washington state, a durable power of attorney for health care follows the same execution rules as other powers of attorney under RCW chapter 11.125. That chapter took effect January 1, 2017.

Washington Requirements Under RCW 11.125.050

Section 11.125.050 sets the signing rules.

Sign and Date It

Your Washington medical power of attorney must be signed and dated by you.

Notary or Two Witnesses

Your signature must be either acknowledged before a notary public or attested by two or more competent witnesses. Witnesses sign in your presence and at your direction or request.

If You Cannot Sign

If you are physically unable to sign, you may make a mark. If you cannot make a mark, Washington provides another execution method.

Notarized Signatures Are Presumed Genuine

A signature acknowledged before a notary is presumed to be genuine.

Who Can Witness a Washington Medical Power of Attorney?

Your witnesses cannot be related to you or to your agent. That covers blood, marriage, or state registered domestic partnership, so check your agent’s family ties as well as your own.

Witnesses also cannot be your home care providers. Nor can they be care providers at an adult family home or long-term care facility where you live. If finding two witnesses who clear these rules is hard, have your Washington medical power of attorney notarized instead.

Match the State Agency Wording

Washington’s Department of Social and Health Services uses a simple witness statement on its own power of attorney forms. Each witness confirms they are not related to you and do not provide care for you at home or in a long-term care facility.

How to Sign Your Washington Medical Power of Attorney

Prepare your Washington medical power of attorney form with these steps:

  1. Name your health care agent and an alternate.
  2. Describe the health care decisions your agent may make.
  3. Decide between a notary and two competent witnesses.
  4. Check that no witness is related to you or your agent, or is your care provider.
  5. Sign and date the document in their presence.
  6. Share copies with your agent and your medical providers.

What to Include in Your Washington Form

A clear Washington health care power of attorney usually covers:

  • Your agent and any alternates
  • The scope of health care decisions your agent may make
  • Any treatment instructions or limits
  • Your signature and date, plus witness attestations or a notary acknowledgment

Keep the signed original safe and tell your agent where it is kept. Your agent may need to show it to a hospital, clinic, or pharmacy, so a clean, complete copy saves time. Review the document after major life changes, such as a marriage, divorce, or move, and sign a new one if your choices change.