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Connecticut Durable Medical Power of Attorney Form |
The Connecticut Power Of Attorney For Health Care Decisions form legally permits an appointed person who is often referred to as an `Agent, to make medical welfare decisions regarding a patient should they become incapacitated and unable to do so themself. The form requires two witnesses’ signatures, in accordance with § 19a-575a, § 19a-575.
How to Write
Power Of Attorney
Enter details regarding power of attorney and alternative power of attorneys.
- Principals name.
- Names of power of attorneys.
Witnesses And Notary
Enter details of principal, witnesses and notary.
- Date.
- Principal`s signature.
- Witnesses signatures.
- Witnesses addresses.
- County.
- Town.
- Date.
- Name of principal.
- Name of notary.
- Date of expiration of notary.
