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South Carolina Health Care Power of Attorney Form

Medical decision authority operates during mental incapacity; the document’s HIPAA release has a separate, broader timing provision.

Jurisdiction
South Carolina
Purpose
Medical & health care
Source / form version
Publisher file labeled 2020 / 10-20; no newer edition asserted.
Resource format
PDF
Signing
Principal signs and dates; two qualified witnesses sign. Notarization is optional under the statutory form and is not a substitute for the witnesses.
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Sources checked: 2026-11-13. General information, not individual legal advice.

Choose an agent and successors

The Bar’s form names a health care agent and two possible successors. Discuss the role before signing, and supply telephone numbers that are likely to remain useful. Read the restrictions on appointing a treating provider or facility employee; the form explains the family exception. This appointment concerns health care rather than managing ordinary financial accounts.

Sources: [1] [3]

Separate treatment choices from access to records

Read the life-sustaining-treatment and tube-feeding sections separately. Each offers alternatives to initial, and the organ-donation choice is another distinct decision. The medical-records authorization operates even while you remain capable, whereas the agent’s decision-making power depends on incapacity. Existing living-will directions also affect how the agent may act.

Sources: [1] [3]

Use eligible witnesses

The two witnesses complete detailed eligibility declarations. They cannot be the named agent or successor, certain relatives, estate or life-insurance beneficiaries, your treating physician or that physician’s employee, or someone with the listed financial conflicts. No more than one may work for the facility where you are a patient. Keep all seven pages and provide signed copies to the agent and health care team.

Sources: [1] [3]

Common questions

Does the medical form need a notary?

The state’s statutory acknowledgment is optional. Two qualified witnesses are required; the Bar PDF supplies their signature blocks without a notarial block.

Sources: [1] [3]

Can my agent override my decisions while I am capable?

No. Signing this form does not remove your right to make your own health care decisions while you can do so. Explain your current wishes directly to clinicians and your agent.

Sources: [1] [3]

Related forms and guides

Sources and verification

  1. South Carolina Bar: source and instructions (opens in a new tab)
  2. Direct PDF (opens in a new tab)
  3. South Carolina Code §§62-5-503 and 62-5-504 (opens in a new tab)

HTTP 200; seven pages, no AcroForm fields. Last-page witness declarations inspected. Current official §62-5-503 execution rules and §62-5-504 optional acknowledgment checked; notary is not mislabeled as mandatory.

The date above records a source check. It does not certify that a form is suitable for your circumstances or that an attorney has reviewed your document. Read the publisher’s current instructions before use.