POWER OF ATTORNEY FOR
THE BIPOLAR FAMILY
Mental Health, Medical Power of Attorney
Authorizing Inpatient Psychiatric Care
A Mental/Medical Power of Attorney may vary somewhat from state to state, but state-specific versions for most states can be found on the internet. In some states, even if you are married or the parent, you may not be able to have your Bipolar committed without their permission – thus the need for a Power of Attorney form. You may also find yourself unable to influence medication and treatment decisions without such a form.
We recommend that you have at least two (2) copies of this form signed and notarized.
Keep one copy in (each) car and one stored safely away with your files at home. If you are traveling or away from home, the copy in your car will help you deal with any emergency, regardless of the state you are in at the time. The copy at home assures that, if one copy is lost or misplaced, you will always have a backup should need one. You should also provide a copy to your therapist, for their protection.
View, print or save the Mental Health Power of Attorney PDF sample form.
(Download Adobe Reader if needed.)
NOTE: This is a generic form. Each state has its own form, which you can find through your state’s Attorney’s General office or websites. We are not attorneys and provide this only as a temporary form to use until you can get the correct form for your state.
Williamsburg Virginia NASW
March 23, 2013
Palm Springs, CA