MEDICAL POWER OF ATTORNEY:
JACK G. NEAL
ATTORNEY AND COUNSELOR AT LAW

P. O. BOX 1148 ? ROANOKE, TEXAS 76262
1 800 XXX?XXXX ? (FAX) 1 800 XXX?XXXX

Questionnaire1


DIRECTORY

*WILLS
*INSTRUCTION

DOCUMENTS FOR PERIODS OF
PHYSICAL/MENTAL INCAPACITY


DIRECTIVE TO PHYSICIANS (LIVING WILL)

DECLARATION REGARDING
MENTAL HEALTH TREATMENT


MEDICAL POWER OF ATTORNEY

DURABLE POWER OF ATTORNEY

DESIGNATION OF A GUARDIAN

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MEDICAL POWER OF ATTORNEY: This document appoints a person (attorney-in-fact) to make medical decisions for you in the event your physician certifies in writing that you are incompetent to make your own health care decisions. You can place a limitation on the decision making authority of your medical attorney-in-fact. However, this document grants full powers to your medical attorney-in-fact. In any event the medical attorney-in-fact may not consent to the following: (1) involuntary inpatient mental health services; (2) convulsive (electric shock) treatments; (3) psychosurgery; (4) abortion; or (5) the omission of care primarily intended for your comfort. Also your physician cannot give or withhold any treatment if you object, even if you are incompetent.
Duration of the Power can be for definite period or unlimited. If the Power is for a definite period the Power will terminate at the end of such period unless you are incompetent and in that event the Power will remain in effect until you regain your competency. In the event a Guardian is appointed for your person, the Judge appointing the Guardian can revoke, suspend or continue the Medical Power of Attorney.

Revocation of the Medical Power of Attorney can be done at any time provided you are competent.

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