As an attorney who has drafted and reviewed hundreds of advance directives across the Midwest for over a decade, I can tell you that the medical power of attorney Indiana residents use (officially called the “Appointment of Health Care Representative”) is one of the most important yet overlooked estate-planning documents in the state. This single form lets you choose who will make medical decisions for you if you become unable to speak for yourself — whether from surgery complications, dementia, a car accident, or any other incapacitating event.
In this comprehensive guide, I’ll give you a completely free, attorney-reviewed Indiana medical power of attorney form in fillable PDF format that is 100% compliant with Indiana Code § 16-36-7 (2025). You’ll also learn exactly how to complete it, notarize it, avoid the most common mistakes I see in my practice, and understand when it works alongside a living will or HIPAA release.
Important Disclaimer: This article and the downloadable template are for informational purposes only and do not constitute legal advice. Laws change, and your situation may have unique factors. Always consult a licensed Indiana attorney or estate-planning professional before finalizing any advance directive.
In Indiana, the correct legal name is “Appointment of Health Care Representative,” but most people search for “medical power of attorney Indiana,” “Indiana healthcare power of attorney,” or “Indiana power of attorney for health care.” All of these terms refer to the same document authorized under IC 16-36-7.
This form allows you (the “principal”) to appoint one or more health care representatives (your “agent”) to make medical decisions on your behalf when two physicians certify that you lack capacity. Unlike a financial power of attorney, this document only controls health-care decisions — not money or property.
This template is based directly on the statutory language recommended by the Indiana State Department of Health and meets all requirements under Indiana Code Title 16 Article 36 Chapter 7 as of November 2025.
| Document | Purpose | When It Activates | Requires Witness/Notary? |
|---|---|---|---|
| Appointment of Health Care Representative (Medical Power of Attorney Indiana) |
Names who makes decisions for you | When you cannot make or communicate decisions (2 doctors certify) | Two witnesses age 18+ (notary optional but recommended) |
| Living Will | States your wishes about life-sustaining treatment if terminal & irreversible | Only when terminal + cannot communicate | Two witnesses age 18+ |
| POST Form (Physician Orders for Scope of Treatment) | Medical orders for EMTs/doctors about CPR, intubation, etc. | Immediately (bright green form) | Signed by physician + patient/representative |
Most of my clients execute all three documents at the same time for maximum protection.
No. The medical power of attorney (health care representative) names who decides; the living will states what you want when you’re terminally ill.
No, the statutory form is designed for self-completion. However, an attorney can customize limitations and ensure coordination with your overall estate plan.
Not required by statute, but 99% of hospitals and long-term care facilities will not honor it without notarization.
You can appoint co-agents, but they must act unanimously unless you state otherwise. I usually recommend naming successors instead of co-agents to avoid conflict.
Simply complete a new form or write “I revoke all prior health care appointments” and sign/date in front of two witnesses. Notify your old agent and doctor.
Completing your Indiana medical power of attorney form today is one of the kindest gifts you can give your family. I’ve sat with too many families in ICU waiting rooms who had no idea what Mom or Dad would have wanted. Fifteen minutes and a free download can prevent weeks of anguish and thousands in legal fees.
Download the 2025-compliant form above, fill it out, get it witnessed (and preferably notarized), and sleep better knowing your voice will be heard — even if you can’t speak for yourself.
Download Your Free Indiana Medical Power of Attorney (Health Care Representative) Form Now
Stay safe, and feel free to reach out with questions in the comments below.
This article was last updated November 2025. Always verify current law at iga.in.gov.