Free Advance Directive and Medical Power of Attorney Template for Maryland

Planning for future healthcare decisions is essential, especially when facing serious medical conditions. In Maryland, having an Advance Directive, which includes a Medical Power of Attorney (POA), ensures your healthcare preferences are respected even if you are unable to communicate them. This document allows you to designate a trusted individual to make critical healthcare decisions on your behalf, known as your healthcare agent.

In this article, we’ll provide a free, customizable Advance Directive template designed specifically for Maryland residents. It’s important to review this template carefully and consult an attorney to ensure it meets your legal requirements and reflects your wishes.

‍

What Is an Advance Directive and Medical Power of Attorney?

An Advance Directive is a legal document that combines two essential components:

1. Medical Power of Attorney (POA): A legal tool that allows you to appoint a healthcare agent to make decisions on your behalf if you are incapacitated.
2. Living Will: A document that outlines your specific medical treatment preferences, such as life-sustaining measures or organ donation.

For Maryland residents, it’s important to ensure that the Advance Directive complies with state laws, which require specific signing procedures and witnesses.

For more information on Maryland Advance Directives, refer to the Maryland Attorney General's Advance Directive Information or the Maryland Department of Health.

‍

Why Do You Need an Advance Directive in Maryland?

In Maryland, without an Advance Directive in place, healthcare providers may not know your exact wishes if you become incapacitated. This can lead to decisions that may not align with your preferences. Additionally, without a designated healthcare agent, the court may need to appoint a guardian to make decisions for you, which can cause delays or lead to conflicts among family members.

Having an Advance Directive:

• Protects your autonomy by ensuring your healthcare decisions are followed.
• Appoints a healthcare agent you trust to act on your behalf.
• Helps avoid disputes or confusion during medical emergencies.
• Ensures compliance with Maryland's legal requirements for healthcare decisions.

‍

‍

Free Advance Directive and Medical Power of Attorney Template for Maryland

Below is a free, customizable template for creating an Advance Directive in Maryland. Ensure you tailor it to your specific needs, and consult a qualified attorney if necessary.

‍

Advance Directive for Maryland

Part 1: Designation of Health Care Agent

I, [Your Full Name], residing at [Your Address], in the City of [Your City], County of [Your County], State of Maryland, being of sound mind, willfully and voluntarily make known my desire that my healthcare decisions be followed, and I do hereby declare:

Appointment of Agent:

I hereby appoint [Agent's Full Name], residing at [Agent's Address], City of [Agent's City], County of [Agent's County], State of Maryland, as my healthcare agent (also referred to as my health care proxy or attorney-in-fact) to make any and all healthcare decisions for me if I am unable to make or communicate such decisions myself.

If the person named as my agent is unable or unwilling to act on my behalf, I appoint [Alternate Agent's Full Name], residing at [Alternate Agent's Address], City of [Alternate Agent's City], County of [Alternate Agent's County], State of Maryland, as my alternate agent.

Effectiveness:
This Advance Directive shall become effective if I am unable to make or communicate my own healthcare decisions, as determined by my attending physician and one other physician or licensed clinical psychologist who has examined me.

Agent's Authority:

My healthcare agent shall have the full power and authority to make any and all healthcare decisions for me, including but not limited to the following:

1. Consent to or refuse any medical treatment, procedure, or test.
   Initial Here: __________
2. Select my healthcare providers and facilities for treatment.
   Initial Here: __________
3. Access my medical records and share them with my healthcare providers.
   Initial Here: __________
4. Admit me to or discharge me from any hospital, nursing home, or other healthcare facility.
   Initial Here: __________
5. Make decisions regarding life-sustaining treatment, including the withdrawal or withholding of such treatment, in accordance with my wishes expressed in Part 2 of this document.
   Initial Here: __________
6. Make decisions regarding organ and tissue donation.
   Initial Here: __________
7. Handle the disposition of my remains, if not addressed in a separate document.
   Initial Here: __________

‍

Part 2: Living Will / Statement of Patient's Wishes

In this section, you may express your preferences regarding:

• Life-sustaining treatment:
  (e.g., “I wish/do not wish to receive life-sustaining treatment, including ventilators, feeding tubes, etc., if I am terminally ill or in a vegetative state.”)
  Initial Here: __________
• Organ and tissue donation:
  (e.g., “I consent/do not consent to organ and tissue donation after my death.”)
  Initial Here: __________
• Other medical treatments:
  (e.g., “I wish/do not wish to receive pain relief and comfort care, even if it may hasten my death.”)
  Initial Here: __________

‍

Part 3: Signature and Witnesses

By signing below, I declare that I understand the full import of this Advance Directive and sign it freely and voluntarily.

Your Signature: _______________________________
Date: _______________________________

Witnesses:

Under Maryland law, two witnesses are required for the signing of this Advance Directive. Witnesses must not be related to you by blood, marriage, or adoption, nor can they be your healthcare agent or attending physician.

Witness 1:
Name: _______________________________
Signature: _______________________________
Date: _______________________________

Witness 2:
Name: _______________________________
Signature: _______________________________
Date: _______________________________

‍

‍

Important Considerations for Maryland Residents

1. Witness Requirements: Maryland law requires two witnesses who are not your healthcare agent, related to you by blood, marriage, or adoption, and cannot be your attending physician or healthcare provider’s employee.
   More information can be found on the Maryland Attorney General’s Advance Directive page.
2. Discuss with Your Healthcare Agent: Make sure your healthcare agent fully understands your preferences and is willing to carry them out.
3. Consult an Attorney: While this template is legally sound, consulting an attorney ensures that your Advance Directive complies with the latest Maryland laws and reflects your exact wishes.

‍

Why Choose DC Mobile Notary for Your Maryland Advance Directive?

At DC Mobile Notary, we make it easy to notarize your Advance Directive and Medical Power of Attorney. Our mobile notary services allow us to come to your location, ensuring your document is properly notarized and legally valid.

• Convenient Mobile Services: We travel to you, whether at home, the office, or the hospital.
• Experienced Notaries: Our notaries are familiar with Maryland’s legal requirements for healthcare documents.
• Confidential and Professional: Your privacy and the legality of your document are our top priorities.

Contact DC Mobile Notary Today:

• Phone: +1 (202) 247-0837
• Email: support@dcmobilenotary.com
• Website: https://www.dcmobilenotary.com/

‍

Disclaimer

This template is provided for informational purposes only and does not constitute legal advice. Laws may change, and it is recommended to consult with an attorney to ensure this document complies with Maryland law and reflects your healthcare wishes.

‍