You need a Health Care Proxy to ensure that a chosen and trusted family member or friend can make medical decisions for you, if you cannot do so yourself. You should discuss this with your family, and you may want the advice of an attorney when completing a Health Care Proxy. But, sometimes one is needed quickly and there is no time to consult an attorney. For your convenience, we have provided a basic Massachusetts Health Care Proxy that you can fill out, print, and sign. You must enter your name, address and date of birth, along with the name and address of your chosen agent and an alternate agent (in case your first agent cannot act for you). To be valid your Health Care Proxy must be signed by the you (as the Principal) in front of two disinterested witnesses, who must also sign the document. The witnesses cannot be named as Agent, and should not even be close relatives. If you want to use this form, please understand that Adamsky Law Offices is not providing you with any legal services and does not represent you in this matter. This form is provided as a convenience for the public and your use of it includes an understanding and acceptance that you are using it at your own risk without the advice of an attorney.