Download Free Nevada Department of Revenue Power of Attorney Form

Download Free Nevada Department of Revenue Power of Attorney Form

Download and use this form when someone else to act in their place for health care decision matters if the subject i.e. the principal is not able to think for themselves any longer. The exact powers can be decided filling out this form.

Please fill in the form by submitting agents personal information, principals information and the witnesses. Insert the name and address of the person you wish to designate as your agent to make health care decisions for you. Unless the person is also your spouse, legal guardian or the person most closely related to you by blood, none of the following may be designated as your agent: (1) your treating provider of health care; (2) an employee of your treating provider of health care; (3) an operator of a health care facility; or (4) an employee of an operator of a health care facility.

Download Free Nevada Department of Revenue Power of Attorney Form

Download NevadaHealthCarePowerofAttorneyForm.pdf (40KB)

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