North Carolina Statutory Form Health Care Power Of Attorney Page 5
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115. Guardianship provision.
If it becomes necessary for a court to appoint a guardian of my person, I nominate my
health care agent acting under this document to be the guardian of my person, to serve
without bond or security. The guardian shall act consistently with G.S. 35A-1201(a) (5).
6. Reliance of third parties on health care agent.
A. No person who relies in good faith upon the authority of or any representations by my
health care agent shall be liable to me, my estate, my heirs, successors, assigns, or personal
representatives, for actions or omissions by my health care agent.
B. The powers conferred on my health care agent by this document may be exercised by
my health care agent alone, and my health care agent's signature or act under the authority
granted in this document may be accepted by persons as fully authorized by me and with
the same force and effect as if I were personally present, competent, and acting on my own
behalf. All acts performed in good faith by my health care agent pursuant to this power of
attorney are done with my consent and shall have the same validity and effect as if I were
present and exercised the powers myself, and shall inure to the benefit of and bind me, my
estate, my heirs, successors, assigns, and personal representatives.
The authority of my health care agent pursuant to this power of attorney shall be superior
to and binding upon my family, relatives, friends, and others.
7. Miscellaneous provisions.
A. I revoke any prior health care power of attorney.
B. My health care agent shall be entitled to sign, execute, deliver, and acknowledge any
contract or other document that may be necessary, desirable, convenient, or proper in
order to exercise and carry out any of the powers described in this document and to incur
reasonable costs on my behalf incident to the exercise of these powers; provided, however,
that except as shall be necessary in order to exercise the powers described in this document
relating to my health care, my health care agent shall not have any authority over my
property or financial affairs.
C. My health care agent and my health care agent's estate, heirs, successors, and assigns
are hereby released and forever discharged by me, my estate, my heirs, successors, and
assigns and personal representatives from all liability and from all claims or demands of all
kinds arising out of the acts or omissions of my health care agent pursuant to this
document, except for willful misconduct or gross negligence.
D. No act or omission of my health care agent, or of any other person, institution, or
facility acting in good faith in reliance on the authority of my health care agent pursuant to
this health care power of attorney shall be considered suicide, nor the cause of my death for
any civil or criminal purposes, nor shall it be considered unprofessional conduct or as lack
of professional competence. Any person, institution, or facility against whom criminal or
civil liability is asserted because of conduct authorized by this health care power of
attorney may interpose this document as a defense.
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