Connecticut Medical Power of Attorney Form


The Connecticut Medical Power of Attorney is a form that represents an individual’s future health care and medical wishes in writing. As provided by § 19a-575, the wishes stated within must be followed should they become incapacitated to the point when they can no longer actively take part in decisions for their own life, and are unable to direct their physician or advanced practice registered nurse about matters concerning their own medical care.

State Laws & Signing Requirements

State Laws – Chapter 368w

Signing Requirements (§ 19a-575) – In order to lawfully execute a Connecticut Medical Power of Attorney, the Principal must sign and date it in the presence of at least two (2) witnesses.