how to set up an hcpa
to appoint someone as your healthcare power of attorney you may fill out a form that names the individual along with any stipulations that you wish them to have regarding your medical care the form will also list any special requests you may have such as asking for a do not resuscitate dnr order and avoiding interventions that will extend your life some states namely indiana new hampshire ohio texas and wisconsin do not permit a universal power of attorney form and require that you use their state specific form instead to designate your power of attorney 1some states also require witnesses to be present if the individual is in a nursing home or care facility a basic healthcare power of attorney form will require you to list your name birthday date and the identifying information of the individual that you are naming you can also name two back up agents in the event that your first preference is not available or unwilling to take on the role if you live in missouri north carolina south carolina or west virginia the form must be notarized 2 the healthcare power of attorney takes effect immediately once the paperwork is signed 