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Free Louisiana Medical Power of Attorney Forms

Create a Louisiana-compliant healthcare power of attorney to appoint a trusted healthcare agent. Includes HIPAA authorization, end-of-life preferences, and all provisions required under La. R.S. § 40:1151.

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Louisiana Healthcare Power of Attorney
PDFWord
Louisiana-compliant
Page 1 of 5
SG

Written by

Stefan Gol
AH

Fact-checked by

Anderson Hill
JD

Legally reviewed by

John Doe

Last updated March 17, 2026

Louisiana Healthcare Power of Attorney Overview

In Louisiana, a healthcare power of attorney is governed by La. R.S. § 40:1151. This legal document allows you to designate a healthcare agent who can make medical decisions on your behalf if you become unable to make or communicate those decisions yourself. Louisiana law ensures that your healthcare agent has the authority to work with healthcare providers to carry out your wishes regarding medical treatment.

Your healthcare agent can make decisions about medical treatments, surgeries, medications, hospital stays, end-of-life care, and access to your medical records. The healthcare power of attorney typically takes effect only when a physician determines that you are unable to make decisions for yourself, though Louisiana law may allow you to make it effective immediately if you prefer.

Creating a healthcare power of attorney in Louisiana requires 2 witnesses and notarization is required. While Louisiana does not mandate a specific form, the document must meet all requirements under La. R.S. § 40:1151.

No

Statutory form required

2

Witnesses required

Required

Notarization

Yes

HIPAA included

Louisiana Requirements

To create a valid healthcare power of attorney in Louisiana, you must meet the following requirements under La. R.S. § 40:1151:

Important: Louisiana Execution Requirements

Louisiana requires 2 witnesses for a valid healthcare power of attorney. The document must also be notarized. Witnesses cannot include your designated healthcare agent or your treating healthcare provider.

  • Legal Age: You must be at least 18 years old and mentally competent at the time of signing
  • Witnesses: Louisiana requires 2 witnesses who are not the healthcare agent or healthcare provider
  • Notarization: Required in Louisiana
  • Agent Designation: Name a primary healthcare agent and optionally an alternate
  • HIPAA Authorization: Included in statutory form

How to Create Your Louisiana Healthcare Power of Attorney

Follow these steps to create a valid healthcare power of attorney that complies with Louisiana law.

1

Choose Your Healthcare Agent

Select a trusted individual to serve as your healthcare agent in Louisiana. This person should understand your healthcare values, be willing to advocate on your behalf, and be available in case of emergency. Consider naming an alternate healthcare agent as well.

2

Specify Your Healthcare Wishes

Document your preferences regarding medical treatments, end-of-life care, organ donation, DNR orders, and mental health treatment. Be as specific as possible about what treatments you do and do not want under various circumstances.

3

Include HIPAA Authorization

Add HIPAA authorization to ensure your healthcare agent can access your medical records and communicate with your healthcare providers in Louisiana. Without this, providers may legally refuse to share your medical information.

4

Sign with Witnesses and Notarize

Execute the document with 2 witnesses as required by Louisiana law. You must also have the document notarized. Distribute copies to your healthcare agent, physicians, hospital, and family members.

Choosing Your Louisiana Healthcare Agent

In Louisiana, your healthcare agent will have significant authority over your medical care. Choose someone who understands your values and can make difficult decisions under pressure.

  • Trustworthy: Someone who will follow your wishes, not impose their own preferences
  • Accessible: Someone who can be reached quickly and can travel to Louisiana if needed
  • Assertive: Someone who can communicate effectively with medical professionals
  • Emotionally capable: Someone who can handle the stress of making life-or-death decisions

Sample Louisiana Healthcare Power of Attorney

Below is a preview of our Louisiana-specific healthcare power of attorney template.

STATE OF LOUISIANA

HEALTHCARE POWER OF ATTORNEY

La. R.S. § 40:1151

PRINCIPAL (You):

Name: [Your Name]
Address: [Louisiana Address]

HEALTHCARE AGENT:

Name: [Agent Name]
Relationship: [Relationship]
Phone: [Phone]

Louisiana Healthcare Power of Attorney FAQ

Answers to common questions about Louisiana healthcare power of attorney requirements and procedures.

Official Louisiana Resources

Use these official resources to verify Louisiana requirements and access government forms.

Create Your Louisiana Healthcare Power of Attorney

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