South Dakota Medical Power of Attorney Form

The South Dakota Power Of Attorney Form is provided by the state of South Dakota offering the principal the option to give authority over their medical health care to an agent. If the appointed agent becomes unavailable then alternative agents may be proposed. The power of attorney form is drawn up in according with §59-7-1 to -9 and needs two witnesses or a notary. The agent takes power over the health care provided if the principal is no longer able to  themselves for example if they are permanently unconscious or in a coma.  The principal has the right to revoke this power of attorney or state a date until which it is valid.

How to Write

Power Of Attorney For Health Care

The agent`s and alternative agents details must be entered.

  • Name.
  • Address.
  • Telephone number.

The principal must enter details regarding their medical health care treatment.

  • The principal`s instructions and limitations.
  • The principal`s instructions regarding life sustaining treatment.
  • The principal`s instructions regarding artificial hydration and nutrition.



The principal, witnesses and notary must enter their details.

  • Principal`s signature.
  • Witnesses signatures.
  • Date.
  • Witnesses names.
  • State.
  • County.
  • Date.
  • Notary`s name.
  • Principal`s name.
  • Location.
  • Seal.
  • Notary`s signature.