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  • PART II REAL AND PERSONAL PROPERTY AND DOMESTIC RELATIONS
  • TITLE II DESCENT AND DISTRIBUTION, WILLS, ESTATES OF DECEASED PERSONS AND ABSENTEES, GUARDIANSHIP, CONSERVATORSHIP AND TRUSTS
  • CHAPTER 201D HEALTH CARE PROXIES
  • Section 4 Contents of proxy

Section 4. The health care proxy shall:

(i) identify the principal and the health care agent;

(ii) indicate that the principal intends the agent to have authority to make health care decisions on the principal’s behalf;

(iii) describe the limitation, if any, that the principal intends to impose upon the agent’s authority; and

(iv) indicate that the agent’s authority shall become effective if it is determined pursuant to section six that the principal lacks capacity to make health care decisions.