Components of a health care proxy. The new jersey department of health works to ensure that citizens receive appropriate levels of care in every regulated facility.
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The power of attorney section proxy directive is used for appointing a health care representative to make decisions on the principals behalf if they are unable to.
Health care proxy form nj. A health care proxy form lets you choose a person or more than one person you trust to make medical decisions for you if you cant speak for yourself. New jersey health care proxy directive medical poa form also known as a durable power of attorney for health care or advance directive should be executed when one must appoint a health care representative to make medical decisions on behalf of the issuerthis sort of paperwork will usually only come into play when the issuer or principal suffers a traumatic medical event that. If you have any questions contact a member of your healthcare team.
Part i is the new jersey proxy declaration. This part lets you name an adult called your health care representative or re presentative to make decisions about your health careincluding decisions about life sustaining treatmentsif you can no longer speak for yourself. The new jersey commission on legal and ethical problems in the delivery of health care page 1 of 2 proxy directive durable power of attorney for health care designation of health care representative i understand that as a competent adult i have the right to make decisions about my health care.
Health care proxies are allowed in 49 of the 50 states and in the district of columbia. New jersey is home to over 2000 licensed hospitals nursing homes and medical care facilities. The forms used to create a health care proxy may differ from state to state but you generally dont need to use any pre made template as long as you follow certain guidelines.
This form gives the person you choose as your agent the authority to make all health care. About the health care proxy form this is an important legal document. The new jersey medical power of attorney form is a two part document consisting of a living will portion as well as a power of attorney section for health care.
Before signing you should understand the following facts. To view this resource click view and print as pdf on the right. New jersey health care proxy healthcare power of attorney form what is a health care proxy.
This form from the state of new jersey allows you to identify someone who can make decisions on your behalf if you are not able to make them for yourself. The principal can choose to complete one of these sections or both.
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