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State of New Hampshire

Free New Hampshire Medical Power of Attorney Forms

Create a New Hampshire-compliant healthcare power of attorney to appoint a trusted healthcare agent. Includes HIPAA authorization, end-of-life preferences, and all provisions required under N.H. Rev. Stat. § 137-J:2.

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New Hampshire Healthcare Power of Attorney
PDFWord
New Hampshire-compliant
Page 1 of 5
SG

Written by

Stefan Gol
AH

Fact-checked by

Anderson Hill
JD

Legally reviewed by

John Doe

Last updated April 2, 2026

New Hampshire Healthcare Power of Attorney Overview

In New Hampshire, a healthcare power of attorney is governed by N.H. Rev. Stat. § 137-J:2. 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. New Hampshire 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 New Hampshire law may allow you to make it effective immediately if you prefer.

Creating a healthcare power of attorney in New Hampshire requires 2 witnesses and notarization is strongly recommended. While New Hampshire does not mandate a specific form, the document must meet all requirements under N.H. Rev. Stat. § 137-J:2.

No

Statutory form required

2

Witnesses required

Recommended

Notarization

Recommended

HIPAA included

New Hampshire Requirements

To create a valid healthcare power of attorney in New Hampshire, you must meet the following requirements under N.H. Rev. Stat. § 137-J:2:

Important: New Hampshire Execution Requirements

New Hampshire requires 2 witnesses for a valid healthcare power of attorney. Notarization is strongly recommended for added legal protection. 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: New Hampshire requires 2 witnesses who are not the healthcare agent or healthcare provider
  • Notarization: Recommended in New Hampshire
  • Agent Designation: Name a primary healthcare agent and optionally an alternate
  • HIPAA Authorization: Recommended to include separately

How to Create Your New Hampshire Healthcare Power of Attorney

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

1

Choose Your Healthcare Agent

Select a trusted individual to serve as your healthcare agent in New Hampshire. 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 New Hampshire. Without this, providers may legally refuse to share your medical information.

4

Sign with Witnesses

Execute the document with 2 witnesses as required by New Hampshire law. Notarization is strongly recommended for added legal protection. Distribute copies to your healthcare agent, physicians, hospital, and family members.

Choosing Your New Hampshire Healthcare Agent

In New Hampshire, 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 New Hampshire 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 New Hampshire Healthcare Power of Attorney

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

STATE OF NEW HAMPSHIRE

HEALTHCARE POWER OF ATTORNEY

N.H. Rev. Stat. § 137-J:2

PRINCIPAL (You):

Name: [Your Name]
Address: [New Hampshire Address]

HEALTHCARE AGENT:

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

New Hampshire Healthcare Power of Attorney FAQ

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

Official New Hampshire Resources

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

Create Your New Hampshire Healthcare Power of Attorney

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