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A.R.S. § 36-3286

Sample Mental Health Care Power of Attorney Form in Arizona

Verified April 4, 2026 • 57th Legislature, 1st Regular Session

Arizona provides a sample form for creating a mental health care power of attorney. The form is optional. Any writing that meets the requirements of A.R.S. 36-3281 and 36-3282 qualifies, so you are not locked into a specific template.

Title 36, LIVING WILLS AND HEALTH CARE DIRECTIVES

azleg.gov

What This Form Covers

A mental health care power of attorney lets you name someone to make decisions about your mental health treatment if you become incapable of making those decisions yourself. This statute provides a sample form, but the law does not require you to use it. Any document that meets the statutory requirements works.

A person may use any writing that meets the requirements of sections 36-3281 and 36-3282 to create a mental health care power of attorney. The following form is offered as a sample only and does not prevent a person from using other language or another form.

A.R.S. § 36-3286

The sample form covers several key areas: naming a primary and backup agent, consenting to or refusing specific mental health treatments, authorizing inpatient hospitalization, and adding personal instructions about your care preferences. It also includes witness affirmations and an optional acceptance section for the agent you name.

Why Putting Mental Health Wishes in Writing Matters

Mental health crises can make it impossible to communicate your preferences clearly. Without a written plan, treatment decisions may fall to providers who do not know your history or values. A mental health care power of attorney gives your chosen agent the authority to act consistently with your wishes, including decisions about medications, outpatient services, and psychiatric hospitalization.

One important feature of this document: it cannot be revoked while you are found incapable of giving informed consent. This protects your earlier, clear-minded instructions from being undone during a crisis. At all other times, you keep full control to revoke or change any part of the document.

Working with experienced estate planning counsel can help ensure your mental health care power of attorney coordinates with your other advance directives and healthcare documents.

A person may use any writing that meets the requirements of sections 36-3281 and 36-3282 to create a mental health care power of attorney. The following form is offered as a sample only and does not prevent a person from using other language or another form.
View on azleg.gov

This page provides general legal information about Arizona statutes and is not legal advice. For guidance on how this law applies to your situation, speak with a qualified attorney.

Related Questions

Who can make medical decisions for me if I am incapacitated in Arizona?

If you have a health care power of attorney, your named agent decides. If not, Arizona law allows a surrogate (spouse, child, parent) under A.R.S. 36-3231. Without any plan, a court may appoint a guardian.

Why do I need a HIPAA authorization separate from my power of attorney?

A medical power of attorney only works when you are incapacitated. A HIPAA authorization gives your chosen people immediate access to your medical information while you are still competent. Most families need both.

What is the difference between a Healthcare Power of Attorney and a Living Will?

A Healthcare Power of Attorney appoints someone to make medical decisions for you. A Living Will states your preferences for end-of-life treatment. Most estate plans include both documents.

Related Statutes

§ 36-3287Surrogate Rules for Mental Health Care Powers of Attorney
§ 36-3201Health Care Directive Definitions in Arizona
§ 36-3202How to Revoke a Health Care Directive in Arizona

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