Arkansas Advanced Directive/Medical Durable Power of Attorney Form: Free Blank Template Downloads

An Arkansas advanced directive/medical power of attorney grants an Health Agent to act on behalf of the Principal authority to make medical decisions for the individual if they cannot do so themselves. Have this document in place before scheduled surgeries or medical procedures involving anesthesia, and it is also helpful in case of unforeseen hospital admissions.

Last updated July 24th, 2024

An Arkansas advanced directive/medical power of attorney grants an Health Agent to act on behalf of the Principal authority to make medical decisions for the individual if they cannot do so themselves. Have this document in place before scheduled surgeries or medical procedures involving anesthesia, and it is also helpful in case of unforeseen hospital admissions.

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An Arkansas medical power of attorney allows an individual (the principal) to designate an agent to make medical decisions on their behalf. This includes authority over financial or medical matters, although the agent can be assigned to handle any legal matter on behalf of the principal.

Standard Power of Attorney Forms – PDF

Law Alert ⚖️

Arkansas Statutes – Arkansas Healthcare Decisions Act

Source: Ark. Code § 20-6-103

What happens if you do not have a Health Care Advance Directive form in Arkansas?

If you do not have an Advance Directive in Arkansas and are unable to communicate for yourself, the healthcare provider will find a surrogate decision-maker for you.

Who is the Surrogate?

The surrogate must be an adult who has shown special care and concern for you, knows your personal values, is reasonably available, and is willing to take on this role. The healthcare provider will consider the surrogate’s ability to make decisions based on your wishes or best interests, their relationship with you, and their demonstrated care and concern.

How will the Surrogate be chosen?

The healthcare provider will first consider your spouse (if not legally separated), then an adult child, then a parent, then an adult sibling, followed by any other relative or person who meets the requirements.

What if there are no Surrogate options?

If no surrogate is available, the healthcare provider will decide after consulting with an institutional ethics committee or a second physician. Your healthcare provider or employees cannot be your surrogate, except for a designated relative.

Source: Arkansas Code §20-6-105: Designation of Surrogate

Arkansas Advanced Directive: Preview Template Sample

Example:

ARKANSAS ADVANCE DIRECTIVE MEDICAL DURABLE POWER OF ATTORNEY FORM

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