Missouri Medical Power of Attorney Form

Missouri medical power of attorney form screenshot

A Missouri Medical Power of Attorney is a legal document that lets you appoint someone to make important decisions about your healthcare if you’re unable to communicate.

An MPOA protects your wishes by allowing the person you choose, the “agent” or “attorney-in-fact,” to carry out your instructions for care and treatment and make decisions in your best interest.

Laws

Signing Requirements § 404.705(3): You need to sign the medical power of attorney document in the presence of a notary public.

Revocation § 404.850: You can revoke a Missouri medical power of attorney by communicating the revocation to your agent or health care provider. If you wish to have a written record of it, you can complete a revocation of power of attorney form.

Sample

Missouri medical power of attorney form screenshot

Missouri medical power of attorney form screenshot

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Missouri medical power of attorney form screenshot

The document above is a sample. Please note that the language you see here may change depending on your answers to the document questionnaire.