This is an example of a completed Power of Attorney for Health Care Decisions. The person signing the Power of Attorney has chosen his primary Attorney-in-Fact ("Agent") and a second Attorney-in-Fact in the event the first person is unable or unwilling to act. The Principal has given his Agent wide latitude in dealing with the Principal's health care decisions. Each of the powers listed in this example may be chosen or not chosen, depending upon the Principal's desires.
(The page breaks shown on this Example Document are not as they normally appear.)