West Virginia Medical Power of Attorney is a legal document granting rights to a representative when the signing principle is unable to take healthcare decisions on his/her own. The power of attorney is a two-page document. It highlights the governing conditions for the grant of permission under various circumstances. The power of attorney sanctions the rights of decision-making during medical treatment, medication, surgical treatment, nursing care, hospitalization, treatment in a nursing home and/or other facility, as well as home health care.
The power of attorney is a comprehensive document and it discusses various probabilities of future decision-making needs. It also grants the rights to the representative to access medical records, health information, consent to, refuse, and/or withdraw any/all medical treatments or diagnostic procedures, as well as an autopsy. Provision of appointing a successor representative is available in the power of attorney. Mentioning Special Directives or Limitations on This Power is not compulsorily necessary, however, it is recommended for clarification. Submit duly filled and notarized power of attorney to WVe-Directive Registry, State of West Virginia via fax at 844-616-1415.
How to Fill the West Virginia Medical Power of Attorney
Mark the box in the upper left portion of page 1 in acceptance to submit the form at WVe-Directive Registry, State of West Virginia. Write name in the prescribed format, street address, city, state, and zip code in addition to date of birth, last four digits of Social Security Number, and gender.
Mention the date of effectiveness of the power of attorney along with the name and address of the signing principle in the boxes provided. Fill representative’s name, address, and phone number. Mention the area code too. The next box requires input of name, address, telephone number, and area code of a successor representative if any. Appointment of successor representative grants the right to act instead of the representative during when the representative is unwilling, unable, or disqualified to take the decision on behalf of the signing principle for him/her.
Type the name of the signing principle in the space presented on page 2. Mention instructions, limitations, or special directives in the space available. Mentioning these directives is not mandatory; however, filling directives ascertains clear guidelines.
Signature of the signing principle is required below the undertaking along with the date. Two neutral witnesses need to sign and write date in the space provided for witnessing the preparation and execution of the power of attorney. Mention name of the state and county in the portion next to the witness signatures.
The last portion of the power of attorney has space reserved for notarization. Notarization by Notary Public of the state is necessary for the legal standing of the power of attorney. Input details like name of the Notary Public, name of the signing principle, and two witnesses. Notary Public signs the power of attorney along with mentioning the date of notarization and date of expiry of the commission.