Healthcare Power of Attorney (HPOA)
What is a Healthcare Power of Attorney?
A Healthcare Power of Attorney (or HPOA) is a legal document that lets you choose who you want as your medical decision-maker. Your medical decision-maker is someone who knows your personal values and what you want for medical care. In a medical emergency, your medical decision- maker can speak for you if you cannot speak for yourself. Your medical decision-maker takes control of your health decisions only when a doctor says you are not able to speak for yourself. Before that time, and when you are recovering, you still make all medical decisions for yourself. The HPOA form also lets you limit what your medical decision-maker can and cannot do.
Why is it important?
An illness or injury can often come without warning. Most people never think there will be a time when they are unconscious or confused, but it happens to people all the time. When patients cannot talk, it is hard to know the right thing to do because the patient cannot tell a doctor what they want. Planning ahead can make sure you get care that follows your goals and values, even if you cannot speak for yourself.
How do I complete an HPOA Form?
- Choose a medical decision-maker (your healthcare power of attorney). Talk to them about what you want and what they can and cannot do.
- Complete and sign a Healthcare Power of Attorney form.
- Ask one person who is not your medical decision- maker (your HPOA) and not a member of your healthcare team to sign the form as your witness.
- Share copies of your HPOA Form. Give a copy to your medical decision-maker and to your healthcare team at your next medical appointment.
- Follow this guide to Upload your HPOA to your MyChart.
- Keep a copy in an easy to find place in case of an emergency.
- Go over your HPOA and make any changes you need from time to time so it stays up to date.
About the form
You may use these forms or another form, as long as it meets the legal requirements of Illinois. The Illinois State Statutory Short Form is created by the Illinois Department of Public Health. The University of Chicago Medicine HPOA form is exactly the same as the Illinois Statutory short form, but has been reformatted to make is easier to read and understand.
Support Materials
These resources from the State of Illinois and UChicago Medicine may be helpful as you create an Advance Care Plan.
- Illinois Power of Attorney for Health Care Form – Plain language version (PDF): This form created at UChicago Medicine is another legal Illinois Power of Attorney for Health Care Form. It is written in plain everyday language that is easier to read and understand.
- Illinois Power of Attorney for Health Care Form – Plain language version (Spanish) (PDF)
- Illinois Power of Attorney for Health Care Form (PDF): This is the Power of Attorney for Health Care form from the Illinois Department of Public Health. It is free to complete. The form does not need to be notarized.
- Living Will Form (PDF): A Living Will is a type of Advance Directive where a person can declare their desire to have life support procedures withheld or withdrawn if diagnosed with a terminal condition.
- What to Know About Healthcare Power of Attorney – This short guide provides a quick overview of what you need to know about completing a Healthcare Power of Attorney form in Illinois and choosing a medical decision maker.
HPOA and Advance Care Planning
The Healthcare Power of Attorney is a type of Advance Directive. Advance Directives are an important element in Advance Care Planning. To learn more about Advance Care Planning, visit our Advance Care Planning page.
