Louisiana

Official Medical Power of Attorney

Enter the Principle information here.

This is the person that is choosing someone to act on their behalf.

Principle First Name

Principle Last Name

Principle Social Security Number

Principle Street Address

Address Line 2

Principle City

Principle ZIP Code

Principle Parish

Click Next to add the agent information.

Enter the Agent information here.

This is the person that will be authorized to make medical decisions on the principle's behalf.

Agent First Name

Agent Last Name

Agent Social Security Number

Agent Street Address

Address Line 2

Agent City

Agent ZIP Code

Agent Parish

Choose one of the following options to complete your Official Louisiana Medical Directive.

That all life-sustaining procedures, including nutrition and hydration, be withheld or withdrawn so that food and water will not be administered evasively.

That all life-sustaining procedures, except nutrition and hydration, be withheld or withdrawn so that food and water will not be administered evasively.

Click FINISH to create your Official Louisiana Medical Power of Attorney and Advanced Medical Directive.

Steps to Creating your Official Louisiana Power of Attorney

Enter Your Information
Enter the Principle Information
Enter the Agent Information
Checkout
Download your Official Louisiana Power of Attorney and Print
Take your Offical Louisiana Power of Attorney document to a Notory with your Agent and Sign
Keep a Signed Copy and give one to your Agent

Do you have questions?

Our Louisiana Power of Attorney experts can give you the answers you need.