Idaho Durable Medical Power of Attorney Form

The Idaho Durable Power Of Attorney For Health Care Will Form for Idaho gives the principal the option to select another person (The `Agent`) to advise on the type of medical health care treatments they will receive if the principal is no longer able to themselves through serious or life-threatening illness. It is a legally binding document in the state of Idaho. State law dictates that only the principal is to sign. However, it is recommended to seek witnesses or a notary. § 39-4510

How to Write

Durable Power Of Attorney For Health Care Will To Live

1) Designation Of Health Care Agent

Enter the principal`s personal details.

  • Name.
  • Address.
  • Telephone number.

Enter the agent`s personal details.

  • Name.
  • Address.
  • Telephone number.

 

When Death Is Imminent

B) The principal must enter specific details of medical treatments and procedures that may be withdrawn or withheld in the event of imminent death.

 

In The Event Of Terminal Illnesss

A) The principal must enter specific details of medical treatments and procedures that may be withdrawn or withheld in the event of terminal illness.

 

Other Special  Conditions

D) The principal must enter specific details of any other special conditions they wold wish to be considered regarding medical health care treatments to prolong life. They must then sign and date the document.

 

If Pregnant

D) The principal must sign to declare that in the event of them being found to be pregnant they agree the document will become void.

 

Designation Of Alternative Agents

7 A & B) Personal details of alternative agents must be entered.

  • Name.
  • Address.
  • Telephone number.

 

Prior Designations Revoked

8) Enter principal`s personal details to declare that any prior Durable Power Of Attorney is revoked.

  • Date.
  • Name.
  • Address.
  • Signature.

 

 

Witnesses

Enter personal details of the witnesses.

  • Witnesses signatures.
  • Witnesses addresses.

Enter details of notary.

  • County.
  • Date.
  • Notary`s name.
  • Principal`s name.
  • Notary`s signature.
  • Date of expiration of notary`s commission.