Power of Attorney

Physician's Statement of Mental Competency

Vicky Randolph Vicky Randolph
How To Use

This review list is provided to inform you about the document in question and assist you in its preparation. This document should accompany any Power of Attorney, if possible. It helps short circuit any challenges to the Power of Attorney.

  1. Make multiple copies and have them attached to the Power of Attorney statement, in your distribution of it and storing of them.

Physician’s Statement of Mental Competency

I, ____________________________(“Physician”), with offices at ______________________________, hereby state that ______________________________ (“Individual”) of _______________________________________, is fully and completely mentally competent in the broadest meaning of that term, and fully capable of taking independent actions as a completely mentally competent person.

__________________
Date

_____________________________
Physician

_____________________________
Witness