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Arkansas Medical Power of Attorney Form 2025: Free Downloadable Template + Complete Guide

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As an attorney who has drafted hundreds of estate planning documents for Arkansas families over the past twelve years, I can tell you that the Arkansas medical power of attorney (also called a Durable Power of Attorney for Health Care) is one of the most important yet frequently overlooked forms. This single document ensures that someone you trust can make medical decisions for you if you ever become unable to speak for yourself—whether due to surgery complications, dementia, a car accident, or any other incapacitating event.

In this comprehensive guide, I’ll give you my exact 2025-updated Arkansas medical power of attorney form that I personally use with clients (completely free), walk you through every section line-by-line, explain Arkansas-specific requirements under Ark. Code Ann. § 20-6-101 et seq., and show you how to make it legally binding today. Everything here complies with current Arkansas law as of November 2025.

What Is a Medical Power of Attorney in Arkansas?

An Arkansas medical power of attorney is a legal document that lets you appoint a trusted person (called your “agent” or “health care proxy”) to make health-care decisions on your behalf when you cannot. Unlike a living will that only covers end-of-life situations, your medical POA covers any situation where you lack decision-making capacity—temporary or permanent.

According to the Arkansas Department of Health and Human Services, over 68,000 Arkansans executed new advance directives in 2024 alone, and medical powers of attorney made up the majority.

Arkansas Medical Power of Attorney vs. Living Will vs. General Durable POA

DocumentCoversArkansas Statute
Medical Power of AttorneyAny health-care decision when you’re incapacitatedArk. Code Ann. § 20-6-101 to 20-6-118
Living WillOnly terminal condition/withdrawal of life supportArk. Code Ann. § 20-17-101 et seq.
General Durable POAFinancial/property matters (does NOT cover medical unless specifically stated)Ark. Code Ann. § 28-68-101 et seq.

Most of my Arkansas clients execute both a medical power of attorney and a living will together for maximum protection.

2025 Arkansas Legal Requirements for a Valid Medical Power of Attorney

Under the Arkansas Healthcare Decisions Act (Act 1268 of 2017, as amended), your form must meet these requirements:

Source: Arkansas Department of Health – Advance Directives and IRS-related estate rules via IRS.gov for gift/estate implications of agents.

Free Arkansas Medical Power of Attorney Form 2025 – Download Here

Click here to download the free Arkansas Medical Power of Attorney template (PDF) – Updated November 2025, attorney-drafted, ready to customize.

The template is fillable, includes optional HIPAA release language, and has space for two alternate agents.

Step-by-Step How to Fill Out the Arkansas Medical Power of Attorney Form

1. Your Information (Principal)

Full legal name, date of birth, and Arkansas address.

2. Appoint Your Primary Agent

Choose someone who lives in or near Arkansas if possible. Include their full name, relationship, address, and phone numbers.

3. Appoint Alternate Agents (Highly Recommended)

I always tell clients: name a second and even third alternate. Life happens—your first choice might be unavailable when needed.

4. Special Powers and Limitations

You can limit or expand authority. Common additions I draft:

5. When the Document Becomes Effective

Arkansas defaults to “springing” powers—only effective when two physicians certify you lack capacity. You can also make it effective immediately.

6. Signature and Date

Sign in front of two qualified witnesses or a notary public (I recommend both).

Sample Filled-Out Arkansas Medical Power of Attorney (Excerpt)

Designation of Health Care Proxy
I, Mary Elizabeth Johnson, born 03/15/1955, residing at 123 Oak Street, Little Rock, Arkansas 72205, appoint:
Primary Agent: Robert James Johnson (Son)
Address: 456 Maple Drive, Benton, Arkansas 72015
Phone: (501) 555-0198

Where to Get It Notarized in Arkansas (2025)

Most banks, UPS Stores, and public libraries offer free or low-cost notarization for Arkansas residents. Many hospitals also have notaries on staff specifically for advance directives.

How to Revoke or Change Your Arkansas Medical POA

You can revoke it anytime you have capacity by:

Common Mistakes Arkansas Residents Make (From My Experience)

Frequently Asked Questions About Arkansas Medical Power of Attorney

Do I need an attorney to create a medical POA in Arkansas?
No, but consulting one prevents costly mistakes.

Is the form different in Fort Smith vs. Fayetteville?
No—Arkansas uses one uniform statewide form.

Does Medicaid planning affect my medical POA?
No, but your financial durable POA does.

Can my agent also be my living will witness?
Yes, as long as they are not also your treating physician.

Final Thoughts From a 12-Year Arkansas Estate Planning Attorney

In my practice, I’ve seen families torn apart because Mom or Dad never completed a simple Arkansas medical power of attorney form. I’ve also seen peace of mind when the right person could step in immediately without court intervention.

Download the free 2025 template above, fill it out this weekend, and sleep better knowing your wishes will be honored.

Important Disclaimer: This article and the downloadable Arkansas medical power of attorney form are for informational purposes only and do not constitute legal advice. Laws change, and your situation may have unique factors. Always consult a licensed Arkansas attorney or qualified professional before executing legal documents.

© 2025 – All rights reserved. Template last verified against Ark. Code Ann. Title 20, Subtitle 6 (November 2025).