• Summer Diegel

Health Care Agent Worksheet

Most of us want to make our own decisions about our bodies and medical care. But sometimes, there are barriers to making and communicating those decisions.

That’s where a health care agent comes in. A health care agent is someone who will advocate for another person's health care decisions if that person in unable to communicate these decisions for themself. This role is often also fulfilled by a health proxy or health power of attorney.

Under many U.S. jurisdictions, a health care proxy is a delegate only for medical decision-making (not finances, administration of will, etc.). To assign a health care proxy, you must have two witnesses present to sign it- a lawyer is not necessary for this step. To assign a power of attorney or a health care power of attorney, you will need to have your decision documented and notarized.

Your health care agent is a person you trust to make decisions for you in case you can’t make them yourself. For example, if you were in an accident that left you unable to communicate, your agent could make choices that honor how you want to be cared for.

Considerations to keep in mind when choosing a health care agent:

  1. Selecting a power of attorney is not about choosing the person closest to you, but rather the one who is trusted and able represent your wishes the best.

  2. You can name anyone you want.

  3. You should feel comfortable discussing your health care wishes with this person.

  4. It is helpful to choose someone who either has some experience in health skills, advocacy, communication, and/or mediation, or who has the needed skills to handle these decisions. Can this person be assertive? Are they understanding and articulate?

  5. Does this person live nearby? Have you had a conversation with them; do they know your health care plans, wishes, and values?

Click the link below to download the Health Care Agent Worksheet PDF! You are welcome to print, share, and use this resource for yourself & within your community.

Health Care Agent Worksheet
Download PDF • 145KB

Are you looking for a little more guidance and information than what is offered in this worksheet? We get that! That's why Summer created this 28-page workbook, which includes information and five guided reflection questions that we have found helpful for creating health care plans and end-of-life documents with clients. This a tool that we wish we had when we first started learning about death care! You can find more information about where to grab your Guided Workbook Download of Summer's Five Essential Reflection Questions for Choosing A Health Care Power of Attorney by following this link.

Thank you,

Summer G. Diegel

©2018 by Sunflower Services, LLC.