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Ohio Medical Power of Attorney Form

Medical decisions begin after the attending physician determines loss of decision-making capacity; the form separately offers earlier protected-information access.

Jurisdiction
Ohio
Purpose
Medical & health care
Source / form version
Undated Ohio Legal Help packet, thirteen pages
Resource format
PDF
Signing
Sign with two eligible adult witnesses or acknowledge before a notary. Agent, alternates, specified relatives and treating professionals cannot be witnesses.
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Sources checked: 2026-11-13. General information, not individual legal advice.

Download the complete Ohio packet

Ohio Legal Help supplies an instruction page followed by the twelve-page health care power. The document includes definitions, agent and alternate details, choices, execution and a statutory notice. Retain these together. The appointment itself revokes earlier health care powers, so compare it with any current appointment before signing.

Sources: [2] [3] [4] [5]

Separate information access from decisions

The form permits an optional mark authorizing immediate access to protected medical information. That is distinct from the agent’s authority to decide treatment, which follows the attending physician’s incapacity determination. Review the powers and any restrictions instead of assuming an information-access choice also transfers decisions while you can still make them.

Sources: [2] [3] [4] [5]

Read the special treatment provisions

Ohio restricts an agent’s decisions concerning life-sustaining treatment and artificial nutrition or hydration. Read the special instructions and mandatory notice carefully and discuss uncertain choices with a clinician or lawyer. For signing, use the qualified two-witness route or a notary, then provide complete copies to the agent, physician and likely hospital. The packet gives detailed signing directions before the form begins. Use the form’s printed page labels when finding the signature section, since the file includes an extra cover.

Sources: [2] [3] [4] [5]

Common questions

Is a court incapacity order necessary to start the health agent’s decisions?

The linked document relies on the attending physician’s determination of lost capacity, not a required court declaration.

Sources: [2] [3] [4] [5]

Is this the same as a financial power?

No. It concerns health care and related information. A financial power is a separate appointment.

Sources: [2] [3] [4] [5]

Related forms and guides

Sources and verification

  1. Ohio Legal Help: source and instructions (opens in a new tab)
  2. Published form (opens in a new tab)
  3. Ohio Revised Code §1337.12, health-power execution (opens in a new tab)
  4. Ohio Revised Code §1337.13, agent authority and limits (opens in a new tab)
  5. Ohio Revised Code §1337.17, required notice (opens in a new tab)

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