Mental Health Care Power of Attorney - Arizona

Arizona · Fillable PDF · Free

This form lets you name an agent to make mental health treatment decisions for you if you are found incapable, and lets you write which treatments you do and do not want. It follows Arizona’s sample form. This form lets you name an agent to make mental health treatment decisions for you if you are found incapable, and lets you write which treatments you do and do not want.

Serving Arizona. Appointments require an Arizona-commissioned notary.

Download Mental Health Care Power of Attorney - Arizona PDF · 4 pages. No account required.

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Who this form is for

This form lets you name an agent to make mental health treatment decisions for you if you are found incapable, and lets you write which treatments you do and do not want. It follows Arizona’s sample form.

What you'll need

The original Mental Health Care Power of Attorney - Arizona packet and its instructions.
Names, dates and supporting records identified in this packet.
Acceptable identification for any notarial act; arrange qualified witnesses when required.

How to complete it

Name your agent and a backup Include addresses and phone numbers.
Write your treatment wishes List treatments you consent to and those you do not. Initial if your agent may admit you to inpatient care.
Add helpful information Health history, medications that worked or did not, people to notify.
Sign before a notary or one qualified witness Use one or the other. We recommend a notary.

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These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.

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