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Colorado medical power of attorney
Download the August 2026 Colorado Durable Power of Attorney for Health Care, the medical durable power of attorney authorized by C.R.S. § 15-14-506, for naming the person who makes your medical decisions when you cannot, with two alternates and your choice of when authority begins. Get it in editable Word and true fillable PDF. Add the completed sample PDF if you want a filled-in reference.
A state-specific durable power of attorney for health care packet, reviewed against the current Colorado statute and ready for instant secure access.
Names your health-care agent and up to two alternates, your election of when authority begins (immediately or upon incapacity), the full scope of health-care and artificial-nourishment authority, an express HIPAA records release, your instructions and limitations, and an optional organ and tissue donation statement.
Colorado requires only your signed written appointment, no witnesses, no notary. A clearly labeled optional addendum provides agent acceptances, two witnesses, and a notary acknowledgment if you want extra evidence or may use the document in another state.
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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.
COLORADO MEDICAL DURABLE POWER OF ATTORNEY
(Colorado Patient Autonomy Act, C.R.S. § 15-14-506)
This document appoints an agent to make health-care decisions for me. Colorado requires the principal’s signed written appointment but imposes no witness or notarial attestation requirement.
1. Appointment of Agent
I appoint the following person as my agent. If that person cannot or will not serve, I appoint the alternates in the order listed.
Agent
Full legal name: __________________________________________________________
Best telephone number: _________________________________________________
Email or alternate telephone: ____________________________________________
Home address: ___________________________________________________________
First Alternate Agent
Full legal name: __________________________________________________________
Best telephone number: _________________________________________________
Email or alternate telephone: ____________________________________________
Home address: ___________________________________________________________
Second Alternate Agent
Full legal name: __________________________________________________________
Best telephone number: _________________________________________________
Email or alternate telephone: ____________________________________________
Home address: ___________________________________________________________
2. When My Agent’s Authority Begins
Initial ONE option:
Initial: Immediately upon my signature, as concurrent authority to obtain records, communicate, and assist me. While I have decisional capacity, my own decisions control, and my agent may never act over my objection.
Initial: When a physician or other qualified medical professional determines that I am unable to make or express my own health-care decisions, and for as long as I remain unable.
3. Grant of Authority
Subject to my instructions and limitations below, my agent may consent to, refuse, or stop any health care, treatment, service, or diagnostic procedure for me, including artificial nourishment and hydration; communicate with health-care personnel; obtain information; and sign forms needed to carry out those decisions. (C.R.S. § 15-14-506(1).)
4. Agent’s Decision Standard
My agent shall follow this instrument and my known wishes. If my wishes are not known, my agent shall act in my best interests as determined by my agent. My agent shall confer with my attending physician concerning my condition. (C.R.S. § 15-14-506(2)–(3).)
5. Medical Records and HIPAA Authorization
My agent is my designated representative and has the same rights of access to my medical records as I do under C.R.S. § 15-14-506(3). As a separate federal-law authorization, I designate my agent as my personal representative under 45 C.F.R. 164.502(g), with authority to request, inspect, copy, use, and disclose my protected health information as needed to exercise this power.
6. Instructions and Limitations
State any directions about life-sustaining procedures, treatment, care, or limits on the agent’s authority. Attach a signed and dated page if more space is needed.
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
7. Optional Organ and Tissue Donation Statement
Optional—leave blank if not elected. I direct that the following anatomical gift be made at my death:
___________________________________________________________________________________
___________________________________________________________________________________
This statement is effective only if executed in accordance with the Revised Uniform Anatomical Gift Act, part 2 of article 19 of title 15, Colorado Revised Statutes. (C.R.S. § 15-14-506(3.5).)
8. Important Colorado-Law Notes
1. My rights are preserved. I may revoke my agent’s authority, and no treatment may be given or withheld over my objection. (§ 15-14-506(4)(a).)
2. Divorce, dissolution, annulment, or legal separation automatically revokes an appointment of my spouse as agent unless I expressly provide otherwise; the remaining provisions survive. (§ 15-14-506(5)(c).)
3. Revoking an agent’s appointment does not revoke this document’s remaining provisions. (§ 15-14-506(5)(d).)
IMPORTANT COLORADO-LAW NOTES — CONTINUED
4. The Act applies to medical durable powers executed on or after July 1, 1992, and this document prevails over a conflicting durable power executed before part 5. (§ 15-14-506(6).)
5. This document does not modify a declaration under C.R.S. § 15-18 unless I specifically say so. (§ 15-14-506(6)(b).)
9. Principal’s Execution
By signing, I make this written appointment. Colorado requires no witness or notarial attestation for this medical durable power of attorney.
Principal’s printed name: ____________________________________________________
Principal’s signature: _______________________________________________________
Date: ______________________________
OPTIONAL ADDENDUM
Recommended, not required by Colorado law — may make this document more acceptable in other states.
Agent and Alternate Acceptances
Agent printed name: _________________________________________________
Agent acceptance signature: ______________________________________________
Date: __________________________
First alternate printed name: _________________________________________________
First alternate acceptance signature: ______________________________________________
Date: __________________________
Second alternate printed name: _________________________________________________
Second alternate acceptance signature: ______________________________________________
Date: __________________________
Witness Attestation
Each witness states that the principal signed or acknowledged this document in the witness’s presence, appeared to be of sound mind and free from undue influence, and is at least 18 years old.
Witness 1 printed name: ____________________________________________________
Witness 1 signature: _______________________________________________________
Date: __________________________
WITNESS ATTESTATION — CONTINUED
Witness 2 printed name: ____________________________________________________
Witness 2 signature: _______________________________________________________
Date: __________________________
Notary Acknowledgment
State of: ________________________________
County of: ________________________________
Acknowledged before me on ______________________ by __________________________.
Notary public’s printed name: ________________________________________________
Notary public’s signature: ___________________________________________________
My commission expires: ________________________________
Legal currency, verified
This medical durable power of attorney appoints an agent to make health-care decisions under C.R.S. § 15-14-506. It includes two alternate-agent designations and an election for when authority begins.
The form reflects the current Colorado Revised Statutes (2025 C.R.S.) and 2026 session laws, including the statute’s decision standard, records-access rule, spouse-agent revocation rule, and 2017 anatomical-gift amendment.
The packet includes agent and alternate appointments, immediate or incapacity-based authority, health-care and artificial-nourishment authority, express federal HIPAA authorization, instructions and limitations, optional anatomical-gift language, and Colorado-law notes.
Colorado requires the principal’s signed written appointment but imposes no witness or notarial attestation requirement. A clearly labeled optional addendum provides agent acceptances, two witnesses, and a notary acknowledgment for possible acceptance in other states.
Your purchase includes the form in editable Word format and as a true fillable PDF, plus a completed fictional sample PDF.
This form is not legal advice and does not replace advice from a Colorado 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 is prepared under C.R.S. § 15-14-506, the medical durable power of attorney statute in Colorado’s Patient Autonomy Act, and carries the statute’s decision standard, records-access rule, and spouse-agent revocation rule. Reviewed against the current Colorado Revised Statutes and 2026 session laws in August 2026.
No. Colorado requires only your signed written appointment, there is no witness or notarial requirement for validity. The packet includes a clearly labeled optional addendum (agent acceptance signatures, two witnesses, and a notary acknowledgment) because some institutions and other states expect them.
You choose. The form lets you elect immediate authority or authority that begins only when a physician determines you cannot make your own health-care decisions. Either way, your agent must follow your known wishes and act consistently with your best interests, as the statute requires.
Under C.R.S. § 15-14-506, a dissolution, annulment, or legal separation revokes your spouse’s appointment as agent unless your document says otherwise, which is why the form also names two alternate agents.
Both contain the same form text. Use the editable Word (.docx) file to type in your details, or the fillable PDF to complete the form on screen. Either way, print the finished document and sign it, your signature belongs on paper.