Durable Power Of Attorney Colorado Form Free – A Colorado medical power of attorney gives a person the ability to appoint someone as their agent for medical care decisions if they find themselves unconscious or mentally incompetent. The agent will be able to access medical records, speak with health care professionals, and be able to make decisions. It is common for a spouse or family member to be the agent. Most importantly, the agent should be someone who is always accessible in case of an emergency.
The Colorado Medical Lasting Power of Attorney for Health Care Decisions is available from this site as a “PDF” document. You can save it directly on your system or in an accessible folder on your machine by selecting the “PDF” button or the “Adobe PDF” link in this section (above).
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Open this form when you determine the identity of your health care agents and what your end-of-life preferences are in relevant scenarios where your medical health is at risk. The title field at the top left of the first page, “I. Appointment of Agent and Substitute,” will open this guide with several requests for information. The first requirement will be that the entry of the name of the principal or advertiser is produced on the first available blank line. This is the party that will authorize an agent to represent their interests during a medical event. If you are the principal and are appointing an agent, provide your name on this line.
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The line labeled “Agent’s Name” finds the full name of the person you want to act as your health care representative or agent. The party named in this line will act with the authority you define through this directive when a medical event makes you unable to speak. It is worth noting that other powers of attorney will normally be given to such an agent by the name of Attorney General.
A few pieces of information will be needed to define the identity of the health care agent. A second blank line indicates that the “agent’s preferred contact phone number” is provided. Because of the nature of this paperwork, it is important to reach your health care agent promptly and reliably.
Continue to the next available blank line where the label “Agent’s email or alternate phone number” requests another way to regularly contact the health care agent. As mentioned earlier, the health care agent or representative you hire should be accessible through information in this area.
Finally, the “Agent’s Home Address” must be documented. This must be the address where the designated health care agent can be physically found. Be sure to report this information correctly as it may be used for important correspondence where signature approval is required for treatment.
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As discussed, it will be important for you to have a health care representative to handle questions and decisions about your health care or treatment if you are disabled or otherwise unable to communicate. That way, if the health care agent or representative you named above can’t be reached, then a backup agent can be named to step into that role. This can be thought of as a wise precaution. A substitute agent will not have authority to represent you until (or until) the health care agent you appointed above is unavailable, steps down, or is terminated. Once this happens, the same original powers you give them will be transferred to the replacement agent. To designate an alternate health care agent, mark his or her full name in the blank line “Name of Alternate Agent #1.”
As with the designated health care agent, the alternative health care “agent’s preferred contact telephone number” must appear next to the name. Go to the second blank line in this field to properly document this information.
Alternate “Agent Email or Alternate Phone Number” must also be produced for display. Remember, this backup information will be requested as a means of contacting an alternate agent when all of the above efforts to obtain a medical decision on your behalf have failed. Thus, make sure that the entries provided here are up-to-date and accurate.
The next line that needs to be reported is “Agent’s Home Address” and this must be provided along with the alternate health care agent’s physical address.
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In addition to a health care agent and a primary health care agent, you can also appoint an alternate health care agent. It should be noted that, like the first substitute agent, the second substitute agent will only be given the principal’s authority if none of the previous agents is willing or able to represent the principal (you). Generally, it is considered a precautionary measure that should be used for safety to ensure that you actually have a power of attorney or health care agent to protect your medical preferences at all times. The “Alternate Agent #2 Name” line can be used to designate this second alternate health care agent if the predecessors (designated health care agent and alternate health care agent) are unable to act in their designated roles.
The continuation of this section will require a second alternative “agent email or alternative telephone number” to be provided for reference.
Finally, the second alternative “Agent’s Home Address” will need to be displayed in the last blank line of the first column field.
Continue to the top of the second column on the first page. The article titled “II. When Powers of Agent Begin” will allow you to indicate when you want your health care agent to have the authority to represent your interests regarding medical treatment. Two statements defining when this document gives such power to your health care agent are displayed with a blank line before each. You, as the principal, must start one to indicate when you want the health care power of attorney to become effective or active. If a health care agent may assume authority to carry out your instructions when you execute this form, begin the blank line next to the words “My signature immediately.”
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If the original authority you define on this paperwork is only available to the health care agent when qualified medical professionals declare you officially unable to communicate effectively, then start a second blank line.
The third section provides a direct report of your preferences regarding health care, treatment, and any related scenarios in which you wish to maintain control (even when unconscious). However, it should be noted that the section “III. Instructions to the agent” will be considered the result of the discussion between the health care agent and yourself, as well as the result of medical advice on the subject. Use the blank lines in this section to describe your instructions about topics such as “life-sustaining procedures, treatment, general care and services” as well as any restrictions, limitations, conditions, and special instructions. While some space is provided, you may want to continue with a well-labeled appendix if you need more room for a full report of your medical instructions and instructions.
The last blank space on this page provides two labels on both sides “Signature of Declaration” and “Date”. Once you have correctly selected your health care agent and specified your medical preferences, you must sign the field labeled “Signature Declaration” then generate the current “Date” from it. If this is done in front of a witness, release the signed paper to that party and instruct him to tender his signature after review. If a notary is employed, follow his instructions for this signature.
“Medical Durable Power of Attorney Addendum – Suggested, Not Required” This paperwork allows for continued validity. The state of Colorado will not require these items but other states will and some municipalities may differ. Thus, enter your name as principal or declarant in the first blank line “1”. Designated Agent Signature, “Then give this document to the health care agent you have chosen.
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The primary health care agent (the first one appointed with the original authority) must read this entire document and the appendix. If the Primary Health Care Agent agrees to take responsibility for his/her role, the “Signature of Primary Agent” letter must be signed by the medical attorney-in-fact you have chosen as the Primary Health Care Agent.
Finally, the primary health care agent must record the current “date” of his signature. If other parties review and sign this document, it must be submitted to their control.
If an alternate health care agent is named, that individual must review the completed primary health care agent and sign their name on the “Alternate Agent #1” line.
Additionally, the alternate health care agent must go to the bottom line to submit his or her “printed name.”
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The “date” when the alternative health care agent signed this paper must be now
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