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Medical Power of Attorney · Massachusetts

Free Massachusetts Medical Power of Attorney Forms

Create a Massachusetts-compliant healthcare proxy to appoint a trusted healthcare proxy. Includes HIPAA authorization, end-of-life preferences, and all provisions required under M.G.L. ch. 201D.

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Last updated March 26, 2026

Massachusetts Healthcare Proxy Overview

In Massachusetts, a healthcare proxy is governed by M.G.L. ch. 201D. This legal document allows you to designate a healthcare proxy who can make medical decisions on your behalf if you become unable to make or communicate those decisions yourself. Massachusetts law ensures that your healthcare proxy has the authority to work with healthcare providers to carry out your wishes regarding medical treatment.

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

Creating a healthcare proxy in Massachusetts requires 2 witnesses and notarization is optional. While Massachusetts does not mandate a specific form, the document must meet all requirements under M.G.L. ch. 201D.

No

Statutory form required

2

Witnesses required

Not required

Notarization

Recommended

HIPAA included

Massachusetts Requirements

To create a valid healthcare proxy in Massachusetts, you must meet the following requirements under M.G.L. ch. 201D:

Important: Massachusetts Execution Requirements

Massachusetts requires 2 witnesses for a valid healthcare proxy. Witnesses cannot include your designated healthcare proxy or your treating healthcare provider.

  • Legal Age: You must be at least 18 years old and mentally competent at the time of signing
  • Witnesses: Massachusetts requires 2 witnesses who are not the healthcare proxy or healthcare provider
  • Notarization: Not required in Massachusetts
  • Agent Designation: Name a primary healthcare proxy and optionally an alternate
  • HIPAA Authorization: Recommended to include separately

How to Create Your Massachusetts Healthcare Proxy

Follow these steps to create a valid healthcare proxy that complies with Massachusetts law.

1

Choose Your Healthcare Proxy

Select a trusted individual to serve as your healthcare proxy in Massachusetts. 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 proxy 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 proxy can access your medical records and communicate with your healthcare providers in Massachusetts. Without this, providers may legally refuse to share your medical information.

4

Sign with Witnesses

Execute the document with 2 witnesses as required by Massachusetts law. Distribute copies to your healthcare proxy, physicians, hospital, and family members.

Choosing Your Massachusetts Healthcare Proxy

In Massachusetts, your healthcare proxy 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 Massachusetts 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 Massachusetts Healthcare Proxy

Below is a preview of our Massachusetts-specific healthcare proxy template.

STATE OF MASSACHUSETTS

HEALTHCARE PROXY

M.G.L. ch. 201D

PRINCIPAL (You):

Name: [Your Name]
Address: [Massachusetts Address]

HEALTHCARE PROXY:

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

Massachusetts Healthcare Proxy FAQ

Answers to common questions about Massachusetts healthcare proxy requirements and procedures.

Official Massachusetts Resources

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

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