Special Power of Attorney for Medical Authorization


I, ___________(1)___________, of __________(2)_________,
hereby appoint ______________(3)________________ of
___________(4)_______________, as my attorney in fact to act
in my capacity to do any and all of the following:

1. Make any and all decisions and authorize all procedures
that _____(5)____ may deem necessary regarding the medical
treatment of my children, _____(6)_____ and/or

The rights, powers, and authority of my attorney in fact to
exercise any and all of the rights and powers herein granted
shall commence and be in full force and effect and shall
remain in full force and effect until
___________(8)_______________ or unless specifically extended
or rescinded earlier by either party.

Dated ___________(9)______________, 20_(10)_.


STATE OF _______(12)____________

COUNTY OF ______(13)____________

BEFORE ME, the undersigned authority, on this _(14)_ day of
_______(15)________, 20_(16)_, personally appeared
___________(17)___________ to me well known to be the person
described in and who signed the Foregoing, and acknowledged to
me that he executed the same freely and voluntarily for the
uses and purposes therein expressed.

WITNESS my hand and official seal the date aforesaid.

                                            NOTARY PUBLIC

                          My Commission Expires:__(19)___


The information in this document is designed to provide an
outline that you can follow when formulating business or
personal plans.  Due to the variances of many local, city,
county and state laws, we recommend that you seek professional
legal counseling before entering into any contract or

Related Articles

Declaration of Life Insurance Trust


Sample legal document: "Declaration of Life Insurance Trust."

General Release


Sample legal document: "General Release."

Contract for Sale and Purchase


Sample legal document: "Contract for Sale and Purchase."

General Power of Attorney


Sample legal document: "General Power of Attorney."

Joint Venture Agreement


Sample legal document: "Joint Venture Agreement."

Cardholder's Inquiry Concerning Billing Error


Sample legal document: "Cardholder's Inquiry Concerning Billing Error."

Declaration of Irrevocable Trust


Sample legal document: "Declaration of Irrevocable Trust."

Agreement Between Owner and Contractor


Sample legal document: "Agreement Between Owner and Contractor."

Contingent Fee Retainer


Sample legal document: "Contingent Fee Retainer."

Cardholder's Report of Lost Credit Card


Sample legal document: "Cardholder's Report of Lost Credit Card."

Terms of Use

All content provided on this website is for general informational purposes only. No warranty is expressed or implied. Your use of this website is subject to our Terms of Use.