Download Free Nebraska Medical Power of Attorney Form

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Download Free Nebraska Medical Power of Attorney Form

Use this form to select a representative to take care of all medical decision making if you are in the position where you are not able to make decisions.

This is a sample, I appoint _________________________, whose address is_________________________________ and whose telephone number is ___________________________ as my attorney-in-fact for healthcare. I appoint ________________________________________, whose address is__________________________________, and whose telephone number is_________________, as my successor attorney-in-fact for health care.

 

Download Free Nebraska Medical Power of Attorney Form

Download NebraskaMedicalPowerofAttorneyForm.pdf (16KB)

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