New York State Health Care Proxy Form

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What is New York State Health Care Proxy Form?

The New York State Health Care Proxy Form is a legal document that allows you to appoint someone you trust to make healthcare decisions on your behalf if you are unable to communicate your wishes. This form ensures that your healthcare preferences are respected and followed in the event that you are incapacitated.

What are the types of New York State Health Care Proxy Form?

In New York State, there is only one standard Health Care Proxy Form that is legally recognized. However, there are specific versions of the form for different languages to ensure that individuals of diverse backgrounds can easily create this important document.

Standard New York State Health Care Proxy Form
New York State Health Care Proxy Form in Multiple Languages

How to complete New York State Health Care Proxy Form

Completing the New York State Health Care Proxy Form is a simple process that can give you peace of mind knowing your healthcare wishes will be honored. Follow these steps to complete the form:

01
Download the New York State Health Care Proxy Form from a trusted source.
02
Fill out your personal information, including your name, address, and contact details.
03
Choose your healthcare agent and alternate agents.
04
Sign and date the form in the presence of two witnesses or a notary public.
05
Share copies of the completed form with your healthcare agent, family members, and healthcare providers.

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Video Tutorial How to Fill Out New York State Health Care Proxy Form

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Questions & answers

You sign the form, along with two witnesses who are at least 18 years old. The agent or alternate agent can't sign as a witness. How can I appoint a health care agent? All competent adults can appoint a health care agent by signing a form called a health care proxy.
In New York, the Health Care Proxy Form is different from the Power of Attorney Form. Here, the Health Care Proxy Form enables you to appoint someone to make medical decisions for you, while the Power of Attorney Form enables you to appoint someone to make financial decisions for you.
All competent adults, 18 years of age or older, can appoint a health care agent by signing a form called a Health Care Proxy. You don't need a lawyer or a notary, just two adult witnesses. Your agent cannot sign as a witness. You can use the form printed here, but you don't have to use this form.
spouse may automatically become your legal proxy. If you think your spouse might find it too difficult to make decisions such as starting or ending treatments if you were seriously ill, it's probably a good idea to choose someone else as your proxy.
Advance directive: Often refers to a combination of the living will and health care proxy documents. Power of attorney: A document—typically prepared by a lawyer—that names someone you trust as your agent to make property, financial, and other legal decisions on your behalf.
The Health Care Proxy Law lets you appoint a competent adult to make decisions about your medical treatment in the event you lose the ability to decide for yourself – including decisions to remove or provide life-sustaining treatment. You can appoint a family member, a close friend, or anyone you choose.
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