Selected Plan: Power Of Attorney Docs Only
Registration Info
Your full legal name is required for your estate planning documents. This would be the name listed on your social security card, passport, or other federal identification documents. Please be sure to include your middle name or initial if listed on your documentation. Provide your details below to get started on your Power of Attorney
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Your Contact Details
Name:
If you are married, your spouse will be selected as your primary agent throughout this estate planning process. Please know that you are not required to have your spouse as your primary agent, and you may choose to have another individual act as your agent.
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Are you married? *
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Yes
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No
Suffix(optional)
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Jr
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Sr
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II
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III
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Other
Gender
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Male
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Female
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Financial Durable POA:
Your Financial Power of Attorney Agent is the person you name to step into your shoes to handle financial matters for you and has legal authority to carry out the powers authorized in the document without the need of court involvement. A Power of Attorney Agent can only act in their capacity as agent for you. When picking your Financial Power of Attorney Agent(s), since this is a financial role, your analysis of who it should be is very similar to how you chose who should serve as your Executor. It is not uncommon to have the same person serving in both roles. By default, powers of attorney are durable, meaning they are effective immediately and remain in effect even if you become incapacitated. If you prefer a springing power of attorney—which becomes effective only upon your incapacitation—or another arrangement, please contact our office for comprehensive planning by calling: 931-651-1900.
Do you want to use the same agents as your personal representative? *
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Yes
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No
Do you want your Primary Agent’s powers to be effective immediately upon signing or only when you are incapacitated? *
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Immediate
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Incapacity Only
* Click the "+" button to add another individual.

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Health Care POA
Your Health Care Power of Attorney Agent will make medical decisions for you if you are incapacitated or otherwise unable to do so yourself. When picking a Health Care Power of Attorney Agent, pick someone who would be comfortable serving in this role. Also, consider whether that person would have similar ideas as you regarding medical care.
Do you wish to use the same agents as your Financial Durable POA? *
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Yes
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No
* Click the "+" button to add another individual.

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Would you like to be an organ donor? *
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Yes﹐for transplantation purposes only
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Yes﹐for transplantation﹐education and/or research
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No
Advance Health Care Directive Agent
Your Advance Health Care Directive Agent will make medical decisions for you if you are incapacitated or otherwise unable to do so yourself. When picking an Advance Health Care Directive Agent, pick someone who would be comfortable serving in this role. Also, consider whether that person would have similar ideas as you regarding medical care.
Do you wish to use the same agents as your Health Care POA? *
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Yes
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No
* Click the "+" button to add another individual.

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Indicate Your Wishes for Quality of Life
By marking “yes” below, I have indicated conditions I would be willing to live with if given adequate comfort care and pain management. By marking “no” below, I have indicated conditions I would not be willing to live with (that to me would create an unacceptable quality of life).
Permanent Unconscious Condition: I become totally unaware of people or surroundings with little chance of ever waking up from the coma. *
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Yes
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No
Permanent Confusion: I become unable to remember, understand, or make decisions. I do not recognize loved ones or cannot have a clear conversation with them. *
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Yes
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No
Dependent in all Activities of Daily Living: I am no longer able to talk or communicate clearly or move by myself. I depend on others for feeding, bathing, dressing, and walking. Rehabilitation or any other restorative treatment will not help. *
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Yes
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No
End-Stage Illnesses: I have an illness that has reached its final stages in spite of full treatment. Examples: Widespread cancer that no longer responds to treatment; chronic and/or damaged heart and lungs, where oxygen is needed most of the time and activities are limited due to the feeling of suffocation. *
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Yes
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No
Indicate Your Wishes for Treatment
CPR (Cardiopulmonary Resuscitation): To make the heart beat again and restore breathing after it has stopped. Usually this involves electric shock, chest compressions, and breathing assistance. *
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Yes
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No
Life Support / Other Artificial Support: Continuous use of breathing machine, IV fluids, medications, and other equipment that helps the lungs, heart, kidneys, and other organs to continue to work. *
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Yes
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No
Treatment of New Conditions: Use of surgery, blood transfusions, or antibiotics that will deal with a new condition but will not help the main illness. *
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Yes
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No
Tube feeding/IV fluids: Use of tubes to deliver food and water to a patient’s stomach or use of IV fluids into a vein, which would include artificially delivered nutrition and hydration. *
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Yes
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No
Other Instructions

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Registration Info Your Contact Details Financial Durable POA: Health Care POA Advance Health Care Directive Agent Indicate Your Wishes for Quality of Life Indicate Your Wishes for Treatment Other Instructions Submission Screen