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The Mental Capacity Act 2005
The Care Act 2014
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Standard Power of Attorney Questions
Your Title
(the person granting the Power of Attorney known as the Donor)
Select one...
Mr
Mrs
Miss
Ms
Dr
Rev
Other
Your Full Legal Name
(the person granting the Power of Attorney known as the Donor)
Your Date of Birth
(the person granting the Power of Attorney known as the Donor)
Your Address
(the person granting the Power of Attorney known as the Donor)
Your Telephone number
(the person granting the Power of Attorney known as the Donor)
Title, Full Legal Name, Date of Birth and Address of your Attorney(s)
Title, Full Legal Name, Date of Birth and Address of your Reserve Attorney
(OPTIONAL)
Title, Full Legal Name and Address of your Certificate Provider
(a person who has known you for over 2 years and will confirm you have mental capacity)
Should your Attorneys Act Jointly and Severally, so that if one Attorney is not available the other Attorney can still make decisions ?
Select one...
Only one Attorney is being appointed
Yes (most popular option for multiple Attorneys)
No
When should your Attorney be able to represent you ?
Select one...
Immediately (most popular & practical option).
Only after your Attorney has medical evidence to prove you have lost Mental Capacity.
Should your Attorney to be able to make decisions about life sustaining treatment ?
Select one...
Yes (most popular option)
No
Do you, your Attorney(s) and the Certificate Provider agree to our
Terms & Conditions
?
Select one...
Yes
No
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