Georgia Statutory Durable Power of Attorney for Health Care


Georgia Statutory Durable Power of Attorney For Health Care is legal instrument signed and issued by you as a signing principal to grant powers to an agent to take health care decisions on your behalf even in case of your incapacitation to do so and death. Durable Power Of Attorney Health Care Act of the Georgia State governs issuance of such power of attorney. You may choose to appoint successor or co-agent/s and nominate a name for guardian using the provision in this legal instrument. Two witnesses must acknowledge your signature on this form. Additional witness like your physician must acknowledge your signing this form when this document is prepared in a nursing facility or hospital.

Georgia Statutory Durable Power of Attorney for Health Care Facts

  • Please refer to the scope of section 31-36-11, 31-36-12, 31-36-13, 31-36-6, 31-36-9, and 31-36-10 of the Durable Power Of Attorney Health Care Act.
  • Please understand the scope of powers you are granting to the agent and/or successor agent and select trustworthy agent who will perform his/her duties in your best interest.
  • You may choose to limit the powers granted to the agent by providing special instructions.
  • Please select your preference for Death-Delaying and/or Life-Sustaining treatments carefully by signing with initials in the space provided for the same.
  • Mark your priority for the date of execution and termination of this Georgia Statutory Durable Power of Attorney For Health Care by signing with initials on the appropriate lines.
  • Optionally, you can attest agent’s specimen signature in this power of attorney form.

How to Fill the Durable Health Care Power of Attorney in Georgia

Step 1: Enter date, your name and address along with agent’s name, address, and phone number on the respective lines. Then provide the instructions to refuse treatment if any, on succeeding lines. Select your preference for Death-Delaying or Life-Sustaining treatments by signing with initials next to the correct option. Then select the mode and date of execution of the power of attorney be marking your response with initials before the correct option.

Step 2: Provide successor agent’s name, address, phone number, and your relation to successor agent. Use separate lines for each successor agent if more than one. Then notify your preferred person as guardian on the following lines. You must provide nominated guardian’s name, address, phone number, and relation with you on the respective lines.

Step 3: Sign before two witnesses and additional witness when applicable in the space provided for the same.

Step 4: Both witnesses must acknowledge your signature on the Georgia Statutory Durable Power of Attorney For Health Care by singing this form. They must enter their printed name and address on separate lines. Please acquire signature along with a printed name and address of an additional witness if you are signing this form in a hospital. Optionally, you may choose to attest the signatures of the agent and successor agent/s by signing next to each signature.

Revoking a Health Care Power of Attorney in Georgia



You may choose to execute the instrument of revocation to cancel this Georgia Statutory Durable Power of Attorney For Health Care under the Code Sections 31-36-6, 31-36-9, And 31-36-10 of The Georgia “Durable Power Of Attorney Health Care Act”. Alternately, court acting on your behalf may order immediate termination of this instrument upon incapacitation of agent and/or successor agent to perform in your best interest.