Health Care Proxy Form - New York

Health Care Proxy
Appointing Your Health Care Agent
in New York State
The New York Health Care Proxy Law allows you to appoint
someone you trust — for example, a family member or close
friend – to make health care decisions for you if you lose the
ability to make decisions yourself. By appointing a health
care agent, you can make sure that health care providers
follow your wishes. Your agent can also decide how your
wishes apply as your medical condition changes. Hospitals,
doctors and other health care providers must follow your
agent’s decisions as if they were your own. You may give
the person you select as your health care agent as little or
as much authority as you want. You may allow your agent
to make all health care decisions or only certain ones. You
may also give your agent instructions that he or she has to
follow. This form can also be used to document your wishes
or instructions with regard to organ and/or tissue donation.
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Health Care Proxy Form - New York PDF

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