Mental healthcare power of attorney

In a mental healthcare power of attorney, you name an adult to make decisions for you about your mental healthcare. That person will make mental healthcare decisions for you only when you cannot
make or communicate those decisions yourself.

Download one of the following formats:

 Mental healthcare power of attorney form (Word 34 KB)
 Mental healthcare power of attorney form (PDF 19 KB)

If you have any questions, please send an email.

HEALTHCARE DIRECTIVES FORMS

Healthcare Directives Information

Healthcare Power of Attorney


Living Will

Mental Healthcare Power of Attorney

Arizona State Registry Program*

*Arizona State Registry offers online registration for your healthcare/ advanced directives.

|   NORTHERN ARIZONA HEALTHCARE HOME PAGE   |   SITE MAP   |   NAH PRIVACY POLICY   |

Northern Arizona Healthcare - 1200 N. Beaver St., Flagstaff, Ariz. 86001 - 928 779-3366
Flagstaff Medical Center - 1200 N. Beaver St., Flagstaff, Ariz. 86001 - 928 779-3366
Verde Valley Medical Center - 269 S. Candy Lane, Cottonwood, Ariz. 86326 - 928 639-6000
VVMC - Sedona Campus - 3700 W. Highway 89A, Sedona, Ariz., 86336 - 928 204-3000