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Alabama health care legal form
Download the August 2026 Alabama Durable Health Care Power of Attorney packet, Ala. Code § 26-1A-404, to name an agent and successor and expressly grant end-of-life authority, with two-witness execution, notary attestation, and written agent acceptance. Get the form in editable Word and true fillable PDF. Add the completed sample PDF if you want a filled-in reference.
A state-specific durable health care power of attorney packet, reviewed against the current Alabama statute and ready for instant secure access.
The form grants health care decision-making authority, including life-sustaining treatment and artificial nutrition and hydration decisions expressly authorized by § 26-1A-404(c)(2).
Two-witness declarations track § 22-8A-4(c)(4), with a notary attestation and written acceptance lines for both the agent and alternate.
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This download includes 1 document in editable Word and fillable PDF formats. Use the Word version for editing; the fillable PDF can be completed on screen, then printed and signed.
Review the complete form text below before purchasing. Your licensed download (editable Word and fillable PDF) is delivered after checkout.
DURABLE HEALTH CARE POWER OF ATTORNEY
STATE OF ALABAMA
COUNTY OF __________________________________
KNOW ALL MEN BY THESE PRESENTS THAT I, ________________________, of ________________________
City of __________________, County of __________________, Alabama, hereby make, constitute and
appoint _______________________________, whose address is ___________________________,
to act as my agent or attorney in fact, to make health care and related personal decisions for me as authorized in this document.
Should ______________________________ for any reason be unable or unwilling to act,
temporarily or permanently, then I appoint _______________________________,
of _________________________ as such agent/attorney in fact, with the same authority.
By this document I intend to create a durable power of attorney upon, and only during, any period of incapacity in which, in the opinion of my health care agent/attorney in fact, after consultation with my health care providers, I am unable to make or communicate a choice regarding a particular health care decision. This document is intended to complement and supplement any Advance Health Care Directive and/or Durable Power of Attorney for financial matters that I may have executed or may execute in the future. It is my desire to receive appropriate medical treatment so long as there is a reasonable hope of recovery, but I do not want my life artificially extended beyond any reasonable hope of recovery to a meaningful quality of life and I do not want to prolong the dying process. I do not intend by this document to authorize or request euthanasia or assisted suicide but to avoid being unwillingly sustained in a condition that is only a semblance of life; or to be allowed to endure pain for which there is treatment available, whether or not recovery is possible.
I grant to my agent full power to make decisions for me regarding my health care. In exercising his/her authority, my agent shall attempt to communicate with me regarding my wishes if I am able to communicate in any way. If my agent cannot determine the choice I want made, then (s)he shall make the choice for me based upon what (s)he believes I would do if I were able, or if unable to so determine, then based upon what (s)he believes to be my best interests. I intend the power given to be as broad as possible, except for any limitations in my Advance Directives or set out hereinafter. Accordingly, unless so limited, my agent is authorized:
To consent to, refuse or withdraw consent to any and all types of medical care, treatment, surgical procedures, diagnostic procedures, medications and use of mechanical or other procedures affecting bodily functions; including, without limitation, artificial respiration, nutritional support and hydration, and cardiopulmonary resuscitation;
• To have access to and have the right to disclose medical reports, records and information to the extent that I would myself;
• To authorize admission to or discharge from any hospital, residential care or related facility, even against medical advice;
• To contract for health care or related services, without the agent incurring personal liability therefore;
• To hire and fire medical, social service or related personnel responsible for my care;
• To authorize or refuse to authorize any medication or procedure to relieve pain, even though such use may lead to temporary discomfort or addiction, or inadvertently hasten the moment of death;
• To make anatomical gifts of part or all of my body for medical purposes,
• To authorize an autopsy and direct disposition of my remains, to the extent permitted by law, and
• To take any other action necessary to effectuate the intent and purpose of this broad grant of powers, including, without limitation, granting any waiver or release from liability required by any health care provider or related agency, and
• To sign any document relative to health care in any way whatsoever and pursuing legal action in my name at the expense of my estate, should that be necessary to enforce compliance with my wishes as determined by my agent pursuant to the authority given herein.
Without in any way limiting the broad powers herein granted, I express the hope that, circumstances permitting, my agent will consult family and friends for their advice and support in arriving at what may be difficult decisions; but the final decisions shall be that of my agent.
No person who relies in good faith upon any representation of my agent or successor agent shall be liable to me, my estate, my heirs or assignees, for recognizing the agent’s authority. Although no compensation of my agent is contemplated, (s)he shall be entitled to reimbursement of any and all reasonable expenses incurred as a result of carrying out any provision of this document.
Invalidity of one or more powers shall not invalidate any others.
I am in full control of my mental faculties and I understand the contents of this document and the effect of this grant of powers to my agent.
Dated this ________ day of ____________________, 20____.
Grantor’s Printed Name: __________________________________________
Grantor’s Signature: ____________________________________________
WITNESSES
I believe the Grantor to be of sound mind and able to make decisions of this kind. I did not sign his/her name and I am not the health care agent. I am not related to the Grantor by blood, adoption or marriage, and not entitled to any part of his/her estate. I am at least 19 years old and am not directly responsible for his/her medical care or expenses.
Signature of Witness #1: _________________________________________
Printed Name of Witness #1: ___________________________________
Date: _________________________
Signature of Witness #2: _________________________________________
Name of Witness #2: __________________________________________
Date: _________________________
ATTESTATION
I, the undersigned authority in and for said County in said State, hereby certify that __________________________, whose name is signed to the foregoing Durable Health Care Power of Attorney, and who is known to me, acknowledged before me on this day that, being informed of the contents of the said document, (s)he executed the same voluntarily, before the witnesses whose names appear above, on the day the same bears date.
Given under my hand this ________ day of __________________, 20____.
Notary Public: __________________________________________________
My commission expires: ________________________________________
SIGNATURES OF AGENTS
I, ________________________________________________, am willing to serve as Health Care Agent.
Agent’s Printed Name: ___________________________________________
Agent’s Signature: ______________________________________________
Date: _________________________
I, ______________________________________, am willing to serve as Health Care Agent if the first-named Agent cannot serve.
Alternate Agent’s Printed Name: _________________________________
Alternate Agent’s Signature: ____________________________________
Date: _________________________
Legal currency, verified
This Alabama health care power of attorney names an agent and successor to make health care and related personal decisions when you cannot make or communicate a choice. It is authorized by Ala. Code § 26-1A-404 and expressly grants authority over life-sustaining treatment and artificial nutrition and hydration under § 26-1A-404(c)(2).
Name your first-choice health care agent and a successor who may serve if the first agent is unable or unwilling to act. A treating health care provider, or a nonrelative employee of that provider, may not serve as agent under § 26-1A-404(c)(5).
The packet includes two witness declarations tracking Ala. Code § 22-8A-4(c): each witness must be at least 19, and the declarations address relationship, estate interest, agent status, and financial responsibility for care. It also includes a notary attestation and written acceptance lines for the agent and alternate under § 22-8A-4(b).
An advance directive has no effect during pregnancy while the attending physician knows of the pregnancy (§ 22-8A-4(e)). If your spouse is your agent, that authority is revoked by divorce, annulment, or legal separation under § 26-1A-404(c)(3).
Your purchase includes an editable Word file and a true fillable PDF you can complete on screen before printing and signing. For your own treatment instructions, see the Alabama Living Will. For property and financial authority, see the Alabama Durable Power of Attorney.
This form is not legal advice and does not replace advice from an Alabama attorney about your circumstances.
ILRG is committed to top quality legal forms that are valid in all states. If you are not 100 percent satisfied after purchase, contact us for a full refund.
Yes. It was verified in August 2026 against Ala. Code § 26-1A-404 and § 22-8A-4 in the 2025 Code of Alabama. Section 26-1A-404 has been unchanged since 2012, and § 22-8A-4 has been unchanged since 2001.
The form uses two witnesses who are at least 19 and declare that they are not related to you, entitled to your estate, your health care agent, or directly responsible for your medical care or expenses, tracking § 22-8A-4(c)(4).
Yes. The form expressly authorizes decisions about life-sustaining treatment, including artificial nutrition and hydration, as permitted by § 26-1A-404(c)(2).
No. Under § 22-8A-4(e), an advance directive has no effect during pregnancy while the attending physician knows of the pregnancy.
Under § 26-1A-404(c)(3), divorce, annulment, or legal separation revokes a spouse-agent’s authority unless the power of attorney provides otherwise.
Both contain the same form text. Word is editable. The true fillable PDF lets you type into every data blank on screen. Print the completed form for wet-ink signatures by the grantor, witnesses, notary, agent, and alternate.