Montana Medical Power of Attorney Form

The Montana medical power of attorney form is a legal document that will permit a Principal to direct powers to a selected Agent in the that event the Principal should become incapacitated and/or incompetent. Health care providers must be advised that whomever  In this event, the Agent will have full authority to assist in making medical decisions that the Principal prefers. This document will not allow permission for the Agent to authorize or access any of the Principal’s financials. This document shall be in full effect in any state. Health care providers must be advised that the decisions made, by the Agent, on behalf of the Principal shall override any opinions of any other person or persons named within the constructs of this document.

The Principal may wish to review the document prior to completion. If the Principal isn’t certain of any portion of it, they may wish to contact an attorney to ensure they are clear with the powers the are granting and to whom.

This document will require notarization. The document may be revoked by the Principal at any time by service or delivery in writing to the Agent.

How to Write

Step 1 – The Parties – Provide:

  • The name of the Prinicpal
  • The City of Principal’s Montana residence
  • AND
  • The name of the delegated Agent
  • The name of the county in which the Agent resides
  • The Principal must read the remainder of the first paragraph
  • The Principal must continue by reviewing paragraphs 1 through 7

Step 2 – Alternate Agents – If the original Agent becomes ill, unwilling or unable to continue acceptance as the Principal’s Agent, the Principal may wish to name others to serve consecutively.

  • Enter the name(s) of any successor Agent’s

Step 3 – Special Instructions –

  • On the lines provided, the Principal may enter any limitations, restrictions and/or any special instructions to be directed to all Agents

Step 4 – Designation of Physician to Determine Competency – The Principal must designate a medical provider to determine and place into writing, the level of competency in which the Principal is capable of their own decision making – Enter:

  • Enter the name of the Physician
  • Read the remainder of the paragrapgh
  • Date the signature in dd/mm/yyyy format
  • The Principal must enter their Signature
  • Provide the Principal’s social security number

Step 5 – Notarization –

Upon completion of the document, the Notary Public will witness the signature(s) and complete the document in acknowledgement.