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814.237.4100 | State College

Free Pennsylvania Health Care Power of Attorney!

Looking for something productive and important to do, instead of watching endless news updates on COVID-19?

Steinbacher, Goodall & Yurchak has made it easy and free to set up a Pennsylvania Health Care Power of Attorney.

A Health Care Power of Attorney allows you to appoint who you would want to make medical decisions on your behalf if you’re unable to make those decisions for yourself due to incapacity.

We’ve made it as easy as possible to complete and record this important part of planning for your second half of life. Use the form below to enter your information and you’ll receive your documents via email complete with instructions on how to properly sign the documents.

Please share with your family and friends, especially anyone age 50 and above! We want to help make as many of our neighbors and member of our communities as possible have a valid Health Care Power of Attorney in place.

Pennsylvania Health Care Power of Attorney

Please complete all required fields below to create your Pennsylvania Health Care Power of Attorney. Required fields have an asterisk (*) next to them. NOTE: If you are married, each spouse will need to complete their own form to generate their own Pennsylvania Health Care Power of Attorney. Some fields below are optional and are noted, and are not required to complete this form.

Please format (XXX) XXX-XXXX
Health Care Agent(s)
Please format (XXX) XXX-XXXX
Please format (XXX) XXX-XXXX
 
Please format (XXX) XXX-XXXX
Please format (XXX) XXX-XXXX
Alternative Health Care Agent(s)
Please format (XXX) XXX-XXXX
Please format (XXX) XXX-XXXX
 
Please format (XXX) XXX-XXXX
Please format (XXX) XXX-XXXX
Guidance for Health Care Agent

The fields in this section are optional.

By submitting your information you are acknowledging the following: (i) use of this form is not a substitute for legal advice; (ii) it does not create an attorney-client relationship between you and Steinbacher, Goodall & Yurchak or any of its lawyers; (iii) you are responsible for the proper execution of your Pennsylvania Health Care Power of Attorney in accordance with Pennsylvania law; and (iv) you consent to being contacted by Steinbacher, Goodall & Yurchak including but not limited to delivery of your Pennsylvania Health Care Power of Attorney.