Health Care Proxy
(Long Form) (VT)

Summary

This template is a long-form health care proxy for use in Vermont. Use this template to appoint an agent to make decisions regarding the principal's health care in the event that the principal becomes incapacitated and unable to make the decisions for himself or herself. This template includes practical guidance, drafting notes, and alternate and optional clauses. Vermont law permits a wide variety of advanced planning issues to be included in a health care proxy, including nominating agents to make health care decisions, directing the type of health care and end of life care to be received, and making arrangements for the disposition of remains. Vt. Stat. Ann. tit. 18, § 9702(a). This is a "long-form," containing both the health care proxy and living will language setting forth the principal's wishes concerning life-sustaining and other medical treatment. Note that the long- form health care proxy contains a provision stating that in the event of any apparent conflict between the expression in the health care proxy of the principal's wishes and the health care agent's good faith decision, the latter shall govern. Use of the long-form may be a convenience, because health care providers are required to ask patients if they have executed "advance directives" (living wills or health care proxies) and to note patients' answers in their medical records. See 42 U.S.C. § 1395cc(f). This template does not address property or financial matters. For a power of attorney template that may be used in Vermont, see Power of Attorney (Durable, General) (VT). For more Vermont-specific documents, see Will for Single Individual (Optional Trust(s) for Children) (VT), Will for Individual with Spouse or Partner (Optional Trust(s) for Spouse and/or Children) (VT), , and Power of Attorney for Minor Child (VT).