New Mexico Medical Power of Attorney
This Medical Power of Attorney is created in accordance with the laws of the State of New Mexico.
I, [Your Full Name], residing at [Your Address], hereby designate the following individual as my agent to make healthcare decisions on my behalf:
[Agent's Full Name]
Address: [Agent's Address]
Phone Number: [Agent's Phone Number]
This authority shall become effective when I am unable to make my own healthcare decisions, as determined by my attending physician.
I grant my agent the authority to make any and all healthcare decisions for me, including but not limited to:
- Choosing healthcare providers and facilities.
- Consenting to or refusing medical treatment.
- Accessing my medical records.
- Making decisions about life-sustaining treatment.
I understand that my agent must act in my best interests and make decisions based on my wishes, if known. If my wishes are not known, my agent should make decisions based on what they believe I would want.
This Medical Power of Attorney shall remain in effect until revoked by me in writing or until my death.
Signed this [Day] day of [Month], [Year].
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Signature of Principal: [Your Signature]
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Witness Signature: [Witness Name]
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Witness Signature: [Witness Name]
Notarization (if required):
State of New Mexico
County of [County]
Subscribed and sworn to before me this [Day] day of [Month], [Year].
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Notary Public Signature
My commission expires: [Date]